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Holmium: Yag Surgical Laser System

Equipment: Holmium: Yag Surgical Laser System

Estimated cost: $50,000-60,000. Includes one-year full warranty. Another manufacturer of this type of laser is Cooke Medical that has the Convergent Laser. Storz also sells a lithotripter but it is more expensive. Quotes have been collected from different companies for this machine. The machine made by Lumenis and sold by Clarion Medical is the industry leader in this field.

Ongoing costs: Ancillary equipment that will need to be purchased in order to perform laser lithotripsy or for using the laser for cutting tissue includes laser fibers of two different diameters and wire baskets to be able to retrieve stone fragments.

Each laser fiber costs about $250 to $1,000 but can be used to treat up to 60 patients if handled carefully. Some machines (Cooke Medical) only allow use of the company’s laser fibers on its machine. With Lumenis, you can use laser fibers from other manufacturers that are cheaper. Each stone basket costs about $250-400 depending on the manufacturer. They are designed for single use in humans, but in veterinary patients, these have been reused many times with gas sterilization in between uses. The VMC can choose to purchase a service contract on the Holium: Yag laser. Clarion Medical provides free laser training and installation training with its equipment and will provide 10 pairs of free safety goggles that need to be worn when the laser is used.

Faculty member: Dr. Elisabeth Snead, Small Animal Clinical Sciences

Service: Small animal medicine

Proposed use:

This is a special laser that can be used to non-surgically treat bladder stones (laser lithotripsy) in male and female dogs and female cats. In addition, it can be used to cut tissue to non-surgically correct ectopic ureters, resect bladder polyps, etc.

Laser lithotripsy is the standard of care for dealing with many urinary stones in people and surgical removal is rarely performed. This procedure is becoming more common in veterinary patients. Advantages of lithotripsy include:

  • non-invasive procedure
  • allows rapid patient recovery from the procedure (same day)
  • can be used to relieve life-threatening obstructions from stones lodged in the lower urinary tract in a timely manor

Having this equipment would allow us to offer lithotripsy and other endourology services (nonsurgical treatment of ectopic ureters) as part of the clinical Small Animal Internal Medicine service at the WCVM Veterinary Medical Centre. This tool would be used to remove bladder and urethral stones in male and female dogs > 6 kg and female cats. This laser would likely be used by multiple services within the VMC (dentistry, surgery, etc.).

Benefits associated with purchasing this equipment would include the following:

  • Potential to increase the referral medicine caseload. We would be only one of two facilities in Western Canada to offer this procedure.
  • It would also help us attract residents to the Small Animal Internal Medicine service. This would allow us to be more competitive with other schools currently offering this service and exposing their IM residents to this procedure.
  • Increased potential for research in endourology. Lithotripsy is a new and exploding area in veterinary internal medicine. Dr. Lulich at the University of Minnesota has expressed interest in collaborating with me on some uroliths research likely using the Canadian Light Source synchrotron. I am spending time with the human urology service at the U of S and the interventional radiology team to continue my training in endourologic procedures by observing them performing lithotripsy and many other endourology procedures in people.
  • Other services may be able to make use of the laser for other procedures (small animal surgery, large animal medicine and surgery, dentistry).
  • Increased anesthetic and imaging procedures (double contrast urethrogram and epidural procedures) for training interns and residents in ancillary services.

For more information, please view the brochure.