Prospective randomised double-blind trial: holmium laser lithotripsy with vs without Moses™ 2.0.
Kimberly A Maciolek, Naren Nimmagadda, Aaron X Lee et al.
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In 30 seconds
This multicentre, randomised, double-blind trial compared Moses 2.0 with standard holmium laser lithotripsy for renal stones 8–20 mm in diameter. Among 153 patients, operative time did not differ significantly between groups (P = 0.73), and blinded video review found no difference in retropulsion (P = 0.13). Complication and stone-free rates were also comparable. Moses 2.0 was associated with lower ratings across several surgeon workload domains and higher overall performance ratings, but the trial found insufficient evidence of improved operative or clinical outcomes.
Key findings
- Operative times did not differ significantly between standard and Moses 2.0 lithotripsy (P = 0.73).
- Moses 2.0 was associated with lower effort, frustration, mental, physical, and temporal workload, and higher overall performance ratings.
- Retropulsion rates did not differ on blinded video review (P = 0.13).
- Complication rates were 13% with standard laser and 10% with Moses 2.0; stone-free rates were 51% and 55%, respectively.
Why it matters
The trial separates perceived procedural workload from patient-facing outcomes: surgeons reported lower workload with Moses 2.0, while operative time, retropulsion, complications, and stone-free rates showed no demonstrated advantage. These findings help frame the potential value of the technology without assuming that improved workload ratings translate into better clinical outcomes.
What to keep in mind
The trial found insufficient evidence of differences in operative time or clinical outcomes; the abstract does not report confidence intervals or longer-term outcomes.