St. Joseph’s hospital rolls out trailblazing treatment for kidney stones

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St. Joseph’s Health Care London is piloting a new minimally invasive treatment that suctions kidney stones from the body, the first hospital in North America to use the new technology.  

The device, which has been used in China but never before in North America, may help stop kidney stones from recurring and may be a potential option for people with large kidney stones that otherwise would have needed surgery, said St. Joseph’s urologist John Denstedt.  

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“This will make the procedure more efficient. It will be quicker for a patient in the operating room, which is always good,” Denstedt said. “We hope, because we’re able to remove these small particles of stone, it will decrease the chance of recurrence down the road.” 

The surgical teams at St. Joseph’s are familiarizing themselves with the new device, a first step toward a full-scale clinical trial in the future, said Denstedt, the recipient of the American Urological Association’s highest honour in 2024. 

Treating kidney stones, pebble-like clusters of crystals that form from minerals and other substances in the kidneys, usually involves inserting a long, telescopic scope through the urethra, into the bladder and up to the kidney. The scope allows doctors to see the kidney stones and use a laser to blast them into pieces. 

After the procedure, called ureteroscopy and laser lithotripsy, the patient passes these tiny bits of kidney stone when they urinate, a process that can be painful. If one of the pieces gets stuck in the urinary tract, it can cause complications, he said.

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Existing devices are more rigid than the new technology, Denstedt said, and aren’t equipped with suction. Sometimes surgeons can pick the tiny fragments out of the kidney in the operating room, but doing so is extremely time-consuming and difficult.

“You could pick them out one by one, but there could be dozens of small kidney stone fragments,” he said. “It prolonged the procedure.”

The new technology, which is flexible enough to get into the tiny nooks and crannies of the kidney, allows surgeons to blast the stones and suction the pieces out of the patient’s body all in one go.  

This method spares patients the pain of passing kidney stone fragments and reduces the risk of recurring kidney stones because it removes pieces that might have otherwise built up again.  

“At least half of all patients who get a kidney stone these days will get one or more recurrent kidney stones,” Denstedt said, adding he does six to seven of these procedures on a single surgical day.  

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“If you leave behind these small fragments, a lot of those patients, 30 to 50 per cent, will come back within two years with more kidney stones.”  

Kidney stones larger than a toonie typically must be removed surgically through an incision in the patient’s back, Denstedt said. St. Joseph’s gets referrals of these patients from across the province.  

The new technology can tackle these large kidney stones, which may reduce the number of patients that need to go under the knife. 

The prevalence of kidney stones has been increasing globally in recent decades, Denstedt said. About 600 patients undergo kidney stone procedures at St. Joseph’s every year.  

“Over the last 30 to 40 years, there has been a very significant increase. . . . It’s a very common medical problem,” he said. “In many populations, it’s 10 to 15 per cent of the population who will get a kidney stone at some point.” 

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