EFFICACY AND SAFETY OF THE TRILOGY LITHOTRIPTER IN MINI-PERCUTANEOUS NEPHROLITHOTOMY: A RETROSPECTIVE STUDY OF 120 PATIENTS

Abstract

Background

Renal stones are a significant cause of urological morbidity worldwide. Mini percutaneous nephrolithotomy (mini-PCNL) has emerged as an effective minimally invasive treatment. The Trilogy lithotripter, combining ultrasonic and pneumatic energy with suction, may improve stone fragmentation and clearance while reducing complications and operative time, though evidence remains limited.

Objectives

To evaluate the efficacy and safety of the Trilogy lithotripter in mini-PCNL regarding stone clearance, operative time, fluoroscopy duration, complication rates, and hospital stay among patients with renal stones.

Methods

This retrospective study included 120 patients undergoing mini-PCNL with the Trilogy lithotripter at a tertiary care center. Patients with renal stones 10–30 mm were included. Preoperative imaging assessed stone characteristics. Outcomes measured were stone-free rate, operative time, fluoroscopy time, complications, and hospital stay. Data were analyzed using SPSS, with results expressed as mean ± standard deviation, and p<0.05 considered statistically significant.

Results

Among 120 patients, the overall stone-free rate was 89%, with higher clearance in stones ≤20 mm (92%) compared to >20 mm (86%) (p=0.045). Mean operative time was 58.3 ± 15.2 minutes, significantly shorter for smaller stones (52.3 ± 10.4 vs 64.8 ± 18.6 minutes, p=0.038). Mean fluoroscopy time was 4.8 ± 1.2 minutes (p=0.081). Minor complications occurred in 10% and major complications in 3% of patients. The average hospital stay was 1.7 ± 0.9 days, with most patients discharged within 48 hours, indicating favorable clinical outcomes.

Conclusion

The Trilogy lithotripter is an effective and safe tool for mini-PCNL, providing high stone clearance rates with acceptable operative time and low complication rates. Its dual-energy and suction mechanism enhances fragmentation and evacuation efficiency. This technology represents a valuable advancement in renal stone management and may improve patient outcomes, though further large-scale prospective studies are required