Dual-energy single-probe lithotripsy versus laser lithotripsy in percutaneous nephrolithotomy: A systematic review and meta-analysis.
7 affiliations
- 1Urology Department, United Lincolnshire Hospitals NHS Trust, Lincoln, United Kingdom.
- 2Princess Basma Teaching Hospital, Irbid, Jordan.
- 3Prince Hamza Hospital, Amman, Jordan.
- 4Faculty of Medicine, Assiut University, Assiut, Egypt.
- 5University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
- 6Mansoura University Urology and Nephrology Center, Mansoura, Egypt.
- 7West Virginia University, Morgantown, WV, United States of America.
Abstract
Introduction
Advances in laser technology have rendered laser lithotripsy an attractive option for lithotripsy during percutaneous nephrolithotomy (PCNL). However, limitations such as lower ablation rates and significant stone retropulsion have been noted, particularly in larger or harder stones. Trilogy is an emerging lithotrite that combines electromagnetic ballistic and ultrasonic energy with integrated suction in a single probe. This design offers theoretical advantages in stone fragmentation speed and debris clearance. This systematic review and meta-analysis aims to evaluate the safety and efficacy of Trilogy vs laser lithotripsy in PCNL.Material and methods
A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library. Studies that compared the efficacy and safety of the Trilogy lithotripsy system to laser-based lithotripsy in adult patients undergoing percutaneous nephrolithotomy were included.Results
Four studies including 260 patients were included. Trilogy lithotripsy demonstrated a statistically significant higher stone-free rate (RR = 1.24, 95% CI: 1.06-1.44; p = 0.005) and higher lithotripsy rate (MD = 33.23 mm³/min, 95% CI: 13.55-52.91; p = 0.0009) compared to laser-based lithotripsy. No statistically significant difference was found between Trilogy and laser lithotripsy regarding operative time (MD = 3.75 minutes, 95% CI: -5.39 to 12.88; p = 0.42) and risk of perioperative complications (RR = 1.44, 95% CI: 0.53-3.91; p = 0.47).Conclusions
Despite technological advances in laser lithotripsy, dual energy lithotripsy probes with suction provide more efficient stone disintegration and superior stone-free rates in PCNL compared to laser lithotripsy without compromising safety or operative time. The combination of ultrasonic, ballistic, and suction capabilities in dual energy probes facilitates stone fragmentation and simultaneous fragment removal while reducing stone retropulsion and lowering the intra-renal pressure, contributing to improved visibility and lower risk of infectious complications.
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BibTeX
@article{mohamed2026dualenergy,
title = {{Dual-energy single-probe lithotripsy versus laser lithotripsy in percutaneous nephrolithotomy: A systematic review and meta-analysis.}},
author = {Tarek Mohamed and Baha' Aldeen Bani Irshid and Mohammad Ghassab Deameh and Hamza Mohamed and Mohamed Ramez and Ahmed Abdelhalim},
journal = {Central European journal of urology},
year = {2026},
month = jun,
doi = {10.5173/ceju.2026.0013},
url = {https://europepmc.org/article/MED/42904135},
note = {CC BY-NC-SA},
}
RIS
TY - JOUR
TI - Dual-energy single-probe lithotripsy versus laser lithotripsy in percutaneous nephrolithotomy: A systematic review and meta-analysis.
AU - Tarek Mohamed
AU - Baha' Aldeen Bani Irshid
AU - Mohammad Ghassab Deameh
AU - Hamza Mohamed
AU - Mohamed Ramez
AU - Ahmed Abdelhalim
PY - 2026
DA - 2026/06/07
JO - Central European journal of urology
DO - 10.5173/ceju.2026.0013
UR - https://europepmc.org/article/MED/42904135
AB - Introduction Advances in laser technology have rendered laser lithotripsy an attractive option for lithotripsy during percutaneous nephrolithotomy (PCNL). However, limitations such as lower ablation rates and significant stone retropulsion have been noted, particularly in larger or harder stones. Trilogy is an emerging lithotrite that combines electromagnetic ballistic and ultrasonic energy with integrated suction in a single probe. This design offers theoretical advantages in stone fragmentation speed and debris clearance. This systematic review and meta-analysis aims to evaluate the safety and efficacy of Trilogy vs laser lithotripsy in PCNL.Material and methods A comprehensive literature search was conducted in PubMed, Scopus, Web of Science, and the Cochrane Library. Studies that compared the efficacy and safety of the Trilogy lithotripsy system to laser-based lithotripsy in adult patients undergoing percutaneous nephrolithotomy were included.Results Four studies including 260 patients were included. Trilogy lithotripsy demonstrated a statistically significant higher stone-free rate (RR = 1.24, 95% CI: 1.06-1.44; p = 0.005) and higher lithotripsy rate (MD = 33.23 mm³/min, 95% CI: 13.55-52.91; p = 0.0009) compared to laser-based lithotripsy. No statistically significant difference was found between Trilogy and laser lithotripsy regarding operative time (MD = 3.75 minutes, 95% CI: -5.39 to 12.88; p = 0.42) and risk of perioperative complications (RR = 1.44, 95% CI: 0.53-3.91; p = 0.47).Conclusions Despite technological advances in laser lithotripsy, dual energy lithotripsy probes with suction provide more efficient stone disintegration and superior stone-free rates in PCNL compared to laser lithotripsy without compromising safety or operative time. The combination of ultrasonic, ballistic, and suction capabilities in dual energy probes facilitates stone fragmentation and simultaneous fragment removal while reducing stone retropulsion and lowering the intra-renal pressure, contributing to improved visibility and lower risk of infectious complications.
SN - 2080-4806
SN - 2080-4873
ER -