Prospective Multi-center Study Comparing Pulsed Tm:YAG Laser to Pulse Modulated Holmium Laser in the Treatment of Nephrolithiasis With FANS Access Sheaths
Prospective Multi-center Study Comparing Pulsed Tm:YAG Laser to Pulse Modulated Holmium Laser in the Treatment of Nephrolithiasis With Flexible And Navigable Ureteric Access Sheath (FANS)
The purpose of this study is to compare two laser technologies that are routinely used during ureteroscopy for the treatment of kidney stones. Specifically, this study will compare a pulsed Thulium:YAG laser to a pulse-modulated Holmium:YAG laser (Moses technology) to evaluate how effective and safe they are when used to break kidney stones.
Primary endpoints include stone-free rate and the zero stone-free rate at a standardized postoperative. Secondary endpoints include total operative time, lasing time (s), laser energy expended (J), efficiency (laser energy expended/stone volume; stone volume/lasing time). These endpoints aim to provide a comprehensive assessment of the clinical effectiveness and procedural efficiency of the two laser systems.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Esteban Emiliani, MD, PhD
- Phone Number: 646-290-4549
- Email: esteban.emilianisanz@nyulangone.org
Study Contact Backup
- Name: Rozalba Gogaj, MD, MPH
- Phone Number: 646-825-5663
- Email: Rozalba.gogaj@nyulangone.org
Study Locations
-
-
Arizona
-
Phoenix, Arizona, United States, 85054
- Mayo Clinic Arizona
-
-
New York
-
New York, New York, United States, 10016
- NYU Langone Health
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Solitary renal stone 7 to 20 mm in size or in the case of multiple stones the conglomerate diameter (additive maximal diameter of all stones on axial imaging of computed tomography) of 7-20 mm is required
- Must be a suitable operative candidate for flexible ureteroscopy per American Urological Association guidelines
- Must be 18 years or older
- Must be able to give consent
- Bilateral ureteroscopy will be permitted , but only the side(s) where the FANS access sheath was used (per surgeon discretion) will be included in the study, however can include both sides as separate units. Subjects will be enrolled only once in the study. No subject will be enrolled more than a single time. For patients undergoing bilateral ureteroscopy, each kidney will be considered a separate unit for stone-related assessments. Peri-patient measures, such as operative time, will be recorded at the patient level. Bilateral cases will be clearly identified and handled consistently to ensure accurate and appropriate interpretation of study outcomes.
- Must be a patient of one of the surgeons participating in this study.
Exclusion Criteria:
- Concomitant stones in the ureter
- Prior radiotherapy to the abdomen or pelvis
- Neurogenic bladder or spinal cord injury
- Pregnancy
- Untreated urinary tract infection (UTI)
- Anatomical abnormalities (including, but not limited to, bifid system, pelvic kidney, horseshoe kidney)
- Prior ipsilateral upper urinary tract reconstructive procedures or history of ipsilateral ureteral stricture
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Pulsed Thulium:YAG laser
Flexible Ureterorenoscopy (URS) for kidney stone treatment will be performed per standard medical care, and surgeons will use the Pulsed Thulium:YAG laser during the procedure.
|
p-Tm:YAG laser lithotripsy with long pulse mode
Other Names:
|
|
Experimental: Pulse-modulated Holmium:YAG laser
Flexible Ureterorenoscopy (URS) will be performed using standard techniques without deviation from routine care, and surgeons will use the pulse-modulated Holmium:YAG laser during the procedure.
|
Ho:YAG with Moses pulse modulation
Other Names:
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Stone-free rate (absence of any fragments ≥ 2mm)
Time Frame: Month 1
|
Month 1
|
|
Zero stone-free rate (absence of any residual fragments confirmed by negative CT scan postoperative at one month)
Time Frame: Month 1
|
Month 1
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Time Frame |
|---|---|
|
Total operative time
Time Frame: From first insertion of instruments to final removal of all instruments (up to 3 hours)
|
From first insertion of instruments to final removal of all instruments (up to 3 hours)
|
|
Lasing time
Time Frame: From start of lasing to end of lasing (up to 1 hour)
|
From start of lasing to end of lasing (up to 1 hour)
|
|
Laser energy expended (J)
Time Frame: From start of lasing to end of lasing (up to 1 hour)
|
From start of lasing to end of lasing (up to 1 hour)
|
|
Laser energy expended per stone volume
Time Frame: From start of lasing to end of lasing (up to 1 hour)
|
From start of lasing to end of lasing (up to 1 hour)
|
|
Stone volume per lasing time
Time Frame: From start of lasing to end of lasing (up to 1 hour)
|
From start of lasing to end of lasing (up to 1 hour)
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Esteban Emiliani, MD, PhD, NYU Langone Health
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Urogenital Diseases
- Male Urogenital Diseases
- Calculi
- Pathological Conditions, Anatomical
- Kidney Diseases
- Urologic Diseases
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urolithiasis
- Urinary Calculi
- Nephrolithiasis
- Pathological Conditions, Signs and Symptoms
- Kidney Calculi
Other Study ID Numbers
Other Study ID Numbers
- 25-01646
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
IPD Sharing Time Frame
IPD Sharing Access Criteria
IPD Sharing Supporting Information Type
- STUDY_PROTOCOL
- SAP
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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