Amy Krambeck, MD, presented “Ureteroscopy: The Latest Advancements and Techniques” during the 44th Annual Ralph E. Hopkins Urology Seminar on February 5, 2025, in Jackson Hole, Wyoming.
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How to cite: Krambeck, Amy. “Ureteroscopy: The Latest Advancements and Techniques.” February 5, 2025. Accessed Apr 2025. https://grandroundsinurology.com/ureteroscopy-the-latest-advancements-and-techniques/
Ureteroscopy: The Latest Advancements and Techniques – Summary
Amy E. Krambeck, MD, explores advancements in ureteroscopy. In this 21-minute presentation, Dr. Krambeck highlights significant improvements in ureteroscope design, ancillary devices, and laser technologies.
Dr. Krambeck shares that digital ureteroscopes enhance visibility, maneuverability, and durability. Miniaturization has improved with smaller flexible scopes, larger working channels, and disposable options, reducing maintenance costs while maintaining image quality. Fragmentation and retrieval devices have evolved, with smaller fibers and softer nitinol baskets improving safety and efficiency. The role of access sheaths remains crucial, offering multiple passes, enhanced visualization, and improved stone-free rates.
Dr. Krambeck emphasizes intrarenal pressure management, illustrating its importance through porcine models. She introduces a novel disposable ureteroscope with integrated pressure monitoring with an access sheath that maintains intrarenal pressures within safe limits. She also introduces emerging suction access sheaths, such as the ClearPetra system. The CVAC system integrates suction directly into the ureteroscope and shows promise in improving stone clearance.
Laser technology continues to advance, with holmium and thulium fiber lasers offering distinct benefits. Pulse modulation may improve efficiency, while thulium lasers provide better retropulsion control but generate higher heat.
Dr. Krambeck advocates a structured approach to ureteroscopy, emphasizing the importance of miniaturization, controlled irrigation, and careful laser use to enhance procedural outcomes while minimizing complications.
About The 44th 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 44th iteration of the meeting took place from February 5th to February 8th, 2025, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Amy E. Krambeck, MD, is a professor of urology at Northwestern University Feinberg School of Medicine in Chicago, Illinois. Dr. Krambeck earned her medical degree from the University of Missouri School of Medicine in Columbia. She completed her urology residency at the Mayo Clinic in Rochester, Minnesota, where she received extensive training and refined her surgical expertise. Following her residency, Dr. Krambeck pursued an endourology fellowship at the Methodist Institute for Kidney Stone Research in Indianapolis, Indiana.
Dr. Krambeck specializes in the surgical and medical management of stone disease and benign prostatic hyperplasia (BPH), and she has alleviated the symptoms of many patients. Her research focuses on the pathogenesis of stone disease and novel treatments for urolithiasis during pregnancy.
Dr. Krambeck began her career as an endourologist at the Mayo Clinic's Department of Urology, where she demonstrated exceptional surgical skills and a strong commitment to patient care. In 2016, Dr. Krambeck joined Indiana University, where she led the benign urologic diseases division until 2020. Her leadership and expertise significantly advanced the division, offering patients innovative treatments for various urologic conditions.
Dr. Krambeck's dedication to her patients, extensive knowledge, and research contributions have established her as a leading figure in urology. She continues to influence the future of urologic care through her clinical excellence and academic endeavors.
