Ep. 337 Advancements in Ureteroscopy for Stone Management with Dr. Karen Stern

How is suction technology changing what it means to be “stone-free” after ureteroscopy? On this episode of BackTable Urology, Dr. Ruchika Talwar welcomes Dr. Karen Stern, endourologist at Mayo Clinic Arizona, for a practical discussion of how ureteroscopy is evolving in the era of suction. They discuss how thin-slice CT has revealed just how much stone typically remains after surgery, why dusting versus fragmenting is now a patient-dependent choice, and what to consider when selecting between suction sheaths, aspiration scopes, and traditional access.

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Timestamps

00:00 - Introduction02:16 - Residual Stone and Defining Success04:59 - Dusting, Fragmentation and Suction Devices07:15 - Patient Selection, OR Setup and Laser Settings11:39 - Evidence, Stone Clearance and Infection Risk15:39 - Community Adoption and Technique Pearls20:05 - Integrated Systems and Artificial Intelligence22:29 - Take-Home Points and Closing Remarks

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More about this episode

The doctors discuss patient selection, OR setup, stenting, and why stones over a centimeter benefit most from a suction approach. Dr. Stern shares her tips for suction device setup, irrigation and suction settings, and how even a short learning curve can make these techniques routine. They review infection risks, evidence on residual stone volume, pearls for community adoption, and look ahead to integrated laser-suction platforms and AI tools that may one day help define when a case is truly finished. Dr. Karen Stern closes with advice for urologists on the fence: every technology works, but the best choice is the one that fits your practice.