Laser fragmentation of renal calculi.

Pulsed Nd YAG lasers will fragment all types of urinary calculi rapidly in air. The fragments are much smaller than with any other technique. Large stones can be split into a few discrete fragments which may prove to be an advantage in that the fragments could then be extracted without leaving multiple small fragments behind. Certain pulsed lasers can be transmitted through fine, flexible glass fibres which are small enough to pass through any sized instrument channel. There is therefore an immediate possibility of using this type of laser in the bladder with carbon dioxide instead of an irrigant. Further experiments are planned in order to investigate the possibility of using this mode of laser in the kidney percutaneously.