Clinical Impact of the Institution of Moses Technology on Efficiency During Retrograde Ureteroscopy for Stone Disease: Single-Center Experience.

To evaluate the clinical benefits of Moses technology compared with the regular mode with the Lumenis Pulse™ P120H holmium laser during ureteroscopy for stone disease. An IRB-approved database of patients with urolithiasis was analyzed for ureteroscopies from January 2020 to December 2020 at an outpatient surgery center. Patients who underwent ureteroscopy with the Lumenis Pulse P120H holmium laser system with the Moses or regular mode were included. Patient characteristics and stone parameters were collected. Operative room parameters were compared, including procedural time, fragmentation/dusting time, lasing time, and total energy used. Complication rates and stone-free rates were also analyzed. Univariate analysis and multiple analysis of covariance controlling for cumulative stone size were performed. Patients with staged procedures were excluded. Of 197 surgical cases, 176 met the inclusion criteria. Moses was utilized in 110 cases and regular mode in 66. There was no difference in cumulative stone size between Moses and regular modes (11.8 ± 7.9 11.6 ± 9.2 mm,  = 0.901). Procedural time (43.5 ± 32.1 39.8 ± 24.6 minutes,  = 0.436), fragmentation/dusting time (20.5 ± 25.3 17.1 ± 16.1 minutes,  = 0.430), lasing time (7.5 ± 11.1 6.7 ± 7.9 minutes,  = 0.570), and total energy used (5.1 ± 6.7 3.8 ± 4.8 kJ,  = 0.093) were also similar. Complications (6.4% 6.1%,  = 0.936) and stone-free rates (52.3% 65.3%,  = 0.143) did not differ. At our institution, Moses technology did not significantly change the procedural time, fragmentation/dusting time, lasing time, or total energy used. Moreover, there were no differences in complications or stone-free rates. There may be technical benefits to the Moses technology not captured in this analysis.