The 4th bi-annual meeting of the EAU Section of Urolithiasis (EULIS17) will bring new, exciting developments on the management of stone disease. EULIS Chairman, Prof. Dr. Kemal Sarica (TR) of the Dr. Lufti Kirdar Training and Research Hospital, introduces some of the meeting’s highly-anticipated updates.
“There are numerous reasons to look forward to the upcoming EULIS meeting. In terms of technology, there is the miniaturization of percutaneous scopes used in clinical practice, new digital flexible ureteroscopes, and newly-designed disposable ‘single-use’ flexible ureteroscopes. This meeting will also showcase emerging concepts of ureteral stone management, the new methods in gaining access to the kidney during percutaneous stone removal, and endoscopic-combined management of large and complex renal stones with percutaneous nephrolithotomy (PNL),” stated Sarica.
He adds that standardisation of the training in endourologic procedures, and management of the stone in cases under anticoagulant medication are significant topics that will also be deliberated during EULIS17.
Major challenges in stone management
Proper diagnosis, stone management through the use of the most appropriate procedures without leaving any significant residual fragment, and major complications pose the biggest challenges according to Sarica.
To address said challenges, Sarica suggested to further increase knowledge and experience particularly in complex cases and paediatric patients. “Moreover, we should also have all the relevant instruments and systems in our operating theatres. We should also remain patient throughout the procedures and follow the guidelines of minimally-invasive stone management whenever applicable. These can increase the success of stone-free rates and decrease complications.”
Sarica expects in majority of cases in the future, there will be “easy, safe and practical puncture of the kidney during PNL and newly-established, precise methods.” He foresees that indications for flexible ureteroscopic stone management will have thinner, digital scopes; and PNL with smaller instruments will make stone removal further less invasive.
He added, “Robotic flexible ureteroscopic management, and disposable ‘single-use’ flexible ureteroscopes will be commonly used in five to ten years. These will lower the cost of flexible uretero-renoscopy (fURS). Biodegradable stents will be customary, and clinical introduction of new and more effective medical agents for stone management will be another advancement in the treatment of stones.”
Lectures at EULIS17
Sarica will be one of the many esteemed speakers at EULIS17. For over 30 years and in addition to the commonly applied procedures performed in cases concerning all age groups, Sarica has focused on the minimally invasive surgical management of stones in paediatric cases with emphasis on the metabolic evaluation and medical management of the calculi in this specific population.
Furthermore, percutaneous management of renal stones (particularly the effect of miniaturization process on this procedure) is one of his favourite areas to work with in the last decade. “I chose these lecture topics that I believe I have enough experience with, so that I can pass it on to the participants of the meeting. These topics will still have some points that need further discussion and examination,” shared Sarica.
In his preparation for EULIS17, he said that he researches and evaluates newly-introduced techniques on treatment concepts of urinary stones, and the minimally-invasive treatment alternatives used in safe and practical management of most urinary calculi. “Technological developments have changed considerably throughout the years. In order to make a contemporary and accurate presentation on a certain urolithiasis-related subject, I have to be remain aware and thorough on the advancements on the medical and surgical management of stones.”