Seth K. Bechis, MD, presented “Lasers in Stone Surgery: Principles and Tips/Tricks for Lasers in URS and PCNL” during the 43rd Annual Ralph E. Hopkins Urology Seminar on January 31, 2024, in Jackson Hole, Wyoming.

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How to cite: Bechis, Seth K. Lasers in Stone Surgery: Principles and Tips/Tricks for Lasers in URS and PCNL.” January 31, 2024. Accessed Jul 2024. https://grandroundsinurology.com/lasers-in-stone-surgery-principles-and-tips-tricks-for-lasers-in-urs-and-pcnl/

Lasers in Stone Surgery: Principles and Tips/Tricks for Lasers in URS and PCNL – Summary

Seth K. Bechis, MD, discusses applications, principles, and tips for using lasers in ureteroscopy and percutaneous nephrolithotomy. He begins by providing an overview of currently available laser technology, including short vs. long pulse and pulse modulation lasers, and their underlying mechanics.

Dr. Bechis then delves into how to match the appropriate laser with the desired treatment result based on the pros and cons of each device. Dr. Bechis provides real-world examples and use cases for laser devices, including:

  • Low Power Holmium Lasers
  • High Power Holmium Lasers
  • Pulse Modulation Lasers
  • Thulium Fiber Lasers
  • Thulium:YAG Lasers

Dr. Bechis concludes by summarizing laser-based approaches to stone treatment, explaining that important considerations include the desired treatment result and the laser’s pulse energy, frequency, and pulse width/modulation. He notes the importance of accounting for unique patient factors, such as anatomy and comorbidities, in addition to the technology’s capabilities when selecting laser treatment.

About The 43rd Annual Ralph E. Hopkins Urology Seminar:

The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 43rd iteration of the meeting took place from January 31st to February 2nd, 2024, in Jackson Hole, Wyoming.

For further educational activities from this conference, visit our collection page.

ABOUT THE AUTHOR

Seth K. Bechis, MD is a board-certified urologist specializing in diseases of the urinary tract, including kidney stones, benign prostatic hyperplasia (BPH) or enlarged prostate, and men's health issues. Dr. Bechis completed fellowship training in laparoscopy/robotics and endourology at the University of California (UC), San Diego School of Medicine, and residency training at Harvard Medical School, Massachusetts General Hospital in Boston. He earned his medical degree from UC San Francisco School of Medicine and holds additional Master of Science training in biomedical research, also from UC San Francisco, focusing on ways to prevent and treat diseases.

As a member of the Comprehensive Kidney Stone Center at UC San Diego Health, Dr. Bechis has a special interest in advanced surgical treatment, medical prevention, and research on kidney stone disease. He has surgical expertise in percutaneous nephrolithotomy (PCNL) for complex stones, ureteroscopy, and shockwave lithotripsy. Dr. Bechis specializes in all procedures of the prostate including minimally invasive procedures such as Rezum water vapor therapy and UroLift, as well as robotic surgery and GreenLight™ Laser photoselective vaporization of the prostate (PVP).

Dr. Bechis serves as the associate program director for the UC San Diego - Kaiser Laparoscopy/Endourology Fellowship in the Department of Urology at UC San Diego School of Medicine. His current research includes improving surgical techniques and clinical outcomes in stone disease, as well as tools for stone diagnosis and opiate-sparing pathways for managing pain. His research has been featured in peer-reviewed medical journals and he has authored chapters for university handbooks.

Prior to joining UC San Diego Health, Dr. Bechis worked at Massachusetts General Hospital and Harvard Medical School, where he taught residents and medical students in the operating room and clinic.