Sri Sivalingam, MD: Suction technology raises the bar for URS

In this video, Sri Sivalingam, MD, MSc, FRCSC, discusses how advances in ureteroscopy, including suction-based technologies, are changing expectations for stone clearance and residual stone burden. Sivalingam is an associate professor of surgery at Cleveland Clinic Lerner College of Medicine at Case Western Reserve University as well as the director of the Center for Endourology and Stone Disease at Cleveland Clinic’s Hillcrest Hospital.

Sivalingam describes the evolution of ureteroscopic stone treatment from laser fragmentation and extraction to dusting techniques that produce fine particles that can passively clear from the urinary tract. Newer suction-based technologies now allow clinicians to actively remove these particles, with approaches including irrigation and aspiration systems, suction-enabled access sheaths, and ureteroscopes with integrated suction.

As these technologies improve the ability to clear stone fragments, Sivalingam says they are also raising the standard clinicians set for their procedures. Rather than simply achieving a traditional definition of stone-free status, clinicians increasingly have the ability to pursue more complete stone clearance and minimize residual stone burden.

“We're still trying to get that perfect technology that renders patients stone free, but our standards, our personal standards, have increased, and the ability to clear stones for our patients have also improved with these technologies,” he concluded.