The Whiston Snare Technique for Loop Extraction of Stents (WHISTLES): A novel technique for the intraureteric assembly of a loop snare for the retrograde extraction of a migrated ureteric stent

Abstract

Background: While ureteric stent removal remains a frequently performed endourological procedure stent migration either proximally or distally can present the endourologist with a significant intraoperative dilemma. In cases where the stent is of large calibre or impacted into the mucosa of the ureter, retrieval may prove refractory to traditional approaches. Objective: To present a further novel procedure: The Whiston Snare Technique for Loop Extraction of Stents (WHISTLES) which allows for intraureteric assembly of a tightening loop through a ureteric catheter thus permitting safe retrieval of a migrated stent. Methods: We describe the procedure as it was performed and have recreated the steps in a laboratory environment. This demonstrates an adaptation of existing materials readily found in most urological theatres and is not a prototypical device. Results: The procedure was successfully performed to allow extraction of the migrated ureteric stent. Conclusion: WHISTLES is a reproducible method for the retrieval of migrated ureteric stents where traditional techniques have failed. Level of evidence: 5