TIPS & TRICKS - Removal of Encrusted Stent

A heavily encrusted stent can be seen here. As the stent could not be removed as a whole, a piece-by-piece removal was done. A semirigid ureteroscope was then inserted parallel to the stent. Due to stent encasement and lack of space, the distal end of the stent was cut by a laser. Using the scope, the encrustations around the stent were then fragmented using the Ho:YAG laser to gradually remove the encrustations. The stent was then cut into pieces using the cutting setting (1-1.5 J, 5-10 Hz). This allowed to create space and a gradual step-by-step proximal progression of the ureteroscope to free the next segment of the stent. The cut fragments of the stent were progressively removed using a basket or grasper. The process was repeated to allow for the complete retrograde removal of the stent. The stent had to be cut into several pieces to finally free it from the encrustations and remove it.