TIPS & TRICKS - Blockage of Stone Basket

How to Release a Stone Basket through the Same Working Channel

While trying to remove an ureteral stone with a basket, the retrieval maneuver can be blocked due to the kinking of the ureter, a narrowed segment of the lumen, an edema of the ureteral mucosa or just by the large size of the fragment that is captured with the basket. In any of these cases, an endourologist must find a suitable trick to overcome the situation.

It should be kept in mind that the working channel of the Olympus semi-rigid ureteroscope allows the endourologist to use the 1.9 Fr basket as well as the 200-micrometer laser fiber. In this way, the stone can be fragmented within the basket. Care should be taken that only the stone and not the basket is touched as the laser can damage the basket. This maneuver also allows the endourologist to perform lithotripsy procedures without risking the pushback of the fragment. When the stone reaches a suitable size that allows downward retraction while it is within the basket, it can be pulled down and out of the ureter easily.