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Fragmentation Vs Dusting With FANS for Renal Stones Less Than 2cm: A Randomized Controlled Study
Sponsor: Bir Hospital
Summary
The use of FANS has changed the operative landscape of RIRS by allowing continuous active suction-assisted clearance of ablated stone material in real time. Use of fragmentation technique in FANS requires high-energy to reduce stone burden into small fragments, followed by active suction of residual fine material. Dusting with FANS, on the other hand, converts the entire stone volume into sub-millimetre particulate that is continuously suctioned away during lasing potentially offering a more streamlined workflow with potentially less energy usage, reduced mechanical stress on the ureteroscope working channel, and fewer scope withdrawals. The combination of TFL dusting with FANS-assisted real-time evacuation may produce stone-free outcomes equivalent or superior to fragmentation, while offering these additional operative efficiencies. Whether dusting using TFL with FANS is non-inferior or indeed superior to fragmentation using TFL with FANS in terms of stone-free rate at one month has not been evaluated in prospective randomised trial yet. This study aims to answer that specific question in patients with renal stone less than 2 cm.
Official title: Fragmentation Vs Dusting Using TFL With FANS for Renal Stones Less Than 2cm
Key Details
Gender
All
Age Range
18 Years - Any
Study Type
INTERVENTIONAL
Enrollment
86
Start Date
2026-08-01
Completion Date
2027-08-07
Last Updated
2026-06-30
Healthy Volunteers
No
Interventions
Dusting
Dusting employs low pulse energy (0.6-0.8 J) at higher frequency (12-15 Hz) to ablate the stone into sub-millimetre powder particles.
Fragmentation
Fragmentation involves delivering high pulse energy (typically 0.6-0.8 J) at low frequency (5-10 Hz) to reduce calculi into retrievable fragments of less than 4 mm.