Techniques
A thin telescope is passed through the urethra and bladder into the ureter and, with a flexible instrument, around the kidney. A holmium:YAG laser fibre fragments the stone under direct vision. This is the international standard for intracorporeal lithotripsy in the ureter and for many renal stones.
The holmium laser cuts stone and coagulates soft tissue. Depending on settings, it can produce larger fragments for basket extraction or fine dust. The Urology NSW kidney stone page notes that holmium:YAG remains the well-established laser platform for this role.
Quoted stone-free rates after flexible ureteroscopy depend on definitions (for example dust versus fragment clearance), stone burden, lower-pole anatomy, and whether imaging is routine. Highly selected single-centre series have reported high clearance for defined cohorts, while broader multi-surgeon registries show more variable complete clearance for renal stones. Your urologist should interpret published ranges against your own CT anatomy and stone volume.
A temporary plastic stent between kidney and bladder is often placed after ureteroscopy to reduce pain and obstruction risk while the ureter heals. It is commonly removed one to two weeks later in rooms or with a brief anaesthetic.
Flexible ureteroscopy with laser lithotripsy has an important role for patients who need long-term anticoagulation or antiplatelet drugs, because it avoids renal puncture (PCNL) and shockwave tissue effects (ESWL). Medication pauses around surgery, if any, are individualised with cardiology or haematology input.
Dr Kooner uses a high-powered Coherent holmium laser with Moses technology, as noted on the Urology NSW kidney stone page. Moses refers to pulse shaping intended to improve energy coupling to the stone; clinical decisions still depend on stone factors and overall patient context rather than device branding alone.
Download Ureteroscopy for stone(s) (BAUS).
The rooms can arrange a consultation to review imaging and outline which form of lithotripsy, if any, fits your situation.