Holmium Laser Stone Surgery: What It Is and What to Expect

បានធ្វើបច្ចុប្បន្នភាពចុងក្រោយ៖ ខែ​សីហា 15, 2026

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If you have a stone that will not pass on its own, laser surgery is one of the two main ways of dealing with it. The idea sounds alarming — a laser, inside the urinary tract — but in practice it is a keyhole procedure with no cuts at all, and it has become the standard treatment for good reasons.

How the operation works

A thin telescope — flexible or semi-rigid — is passed along the natural urinary passage, through the urethra and bladder and up the ureter, until the stone is in view. A laser fibre is then passed down the scope and used to break the stone into fragments small enough to pass, or into dust. There is no incision anywhere on the body. It is done under general or spinal anaesthesia, so you feel nothing during it.

Why the holmium laser specifically

Endoscopic laser stone surgery was first reported by German and British researchers in 1988, with a success rate of around 84%. Its weakness was retropulsion — the laser’s energy pushing the stone back up into the kidney before it could be broken — which sometimes meant converting to open surgery to retrieve it.

Three decades of development later, the Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) laser is the gold standard for endoscopic stone treatment.

• It is strongly absorbed by water, so its energy dissipates within a fraction of a millimetre and does not heat the surrounding urinary tract — the problem that limited some earlier lasers.
• Modern generators cut retropulsion sharply, using pulse-shaping technology that fragments the stone faster while pushing it far less.
• It cannot travel more than about 5 cm in air, which is why it is safe for the surgical team, with no reported eye injuries.
• Reported success of 95–96% for stones at any position in the urinary tract — kidney, ureter or bladder alike. That versatility is what makes it the default.

Laser surgery or shockwave treatment?

This is the choice most stone patients actually face. Shockwave lithotripsy (ESWL) breaks the stone from outside the body with no instrument entering it at all, and at Bangkok Hospital Headquarters it is a daycare treatment — you go home the same day. Laser surgery is more invasive but clears the stone in a single sitting far more reliably, and works on stones that shockwave struggles with.

Which suits you depends on the stone’s size, position and hardness, on your kidney anatomy, and on how quickly the stone needs to be gone. It is a decision worth making with your urologist rather than by reading success rates — the headline figures come from different patient groups.

What to expect afterwards

Most patients go home the same day or the next. Mild burning, urinary frequency and some blood in the urine are normal for the first few days.

The part worth preparing for is the ureteric (DJ) stent, which is often left in place to keep the ureter draining while it settles. It is removed at a follow-up visit after 1–2 weeks, and until then it commonly causes urinary frequency, urgency and a dragging discomfort in the flank. This surprises patients who expected to feel completely better the moment the stone was gone — the stent, not the surgery, is usually what they notice.

Normal daily activity resumes within 1–3 days and full activity within 1–2 weeks. Follow-up imaging confirms the stone has cleared and looks for any residual fragments.

One last thing worth saying: clearing a stone does not stop the next one forming. If this is not your first, it is worth reading about how recurrence is prevented.

ប្រសិនបើអ្នកមានគ្រួសក្នុងតម្រងនោម ឬគ្រួសក្នុងបង្ហួរនោម ហើយចង់ពិភាក្សាអំពីការព្យាបាលដោយឡាស៊ែរ Holmium ដែលមានលក្ខណៈឈ្លានពានតិចតួចបំផុត លោកវេជ្ជបណ្ឌិត Soarawee Weerasopone ផ្តល់ជូនការពិគ្រោះយោបល់ជំនាញនៅទីស្នាក់ការកណ្តាលមន្ទីរពេទ្យបាងកក។. កក់ការពិគ្រោះយោបល់. ការណាត់ជួបនៅមន្ទីរពេទ្យ Samitivej Sriracha អាចត្រូវបានរៀបចំដោយទូរស័ព្ទទៅផ្នែកជំងឺប្រព័ន្ធទឹកនោមតាមរយៈលេខ 088-022-1445.

សំណួរដែលសួរជាញឹកញាប់អំពីការវះកាត់គ្រួសក្នុងតម្រងនោមដោយឡាស៊ែរ Holmium

ការបដិសេធ៖ ខ្លឹមសារនេះត្រូវបានសរសេរ និងពិនិត្យដោយលោកវេជ្ជបណ្ឌិត Soarawee Weerasopone ដែលជាគ្រូពេទ្យឯកទេសខាងប្រព័ន្ធទឹកនោមដែលមានវិញ្ញាបនបត្រនៅទីស្នាក់ការកណ្តាលមន្ទីរពេទ្យបាងកក។ វាត្រូវបានបម្រុងទុកសម្រាប់គោលបំណងអប់រំតែប៉ុណ្ណោះ ហើយមិនមែនជាដំបូន្មានផ្នែកវេជ្ជសាស្ត្រទេ។ មិនមានដំបូន្មានផ្នែកវេជ្ជសាស្ត្រ ការធ្វើរោគវិនិច្ឆ័យ ឬវេជ្ជបញ្ជាត្រូវបានផ្តល់ជូនតាមរយៈបណ្តាញផ្ញើសារផ្ទាល់ខ្លួនទេ។ តែងតែពិគ្រោះជាមួយអ្នកជំនាញថែទាំសុខភាពដែលមានសមត្ថភាព មុនពេលចាប់ផ្តើមការព្យាបាលណាមួយឡើយ។.