Introduction

Kidney stone disease (urolithiasis) remains one of the most common urological conditions in the United States. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health (NIH), approximately 11% of men and 6% of women in the U.S. will develop kidney stones during their lifetime.

Source:
NIDDK - Kidney Stones in Adults
https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones

As the prevalence of stone disease increases, so does the need for minimally invasive surgical management. Procedures such as:

• Flexible ureteroscopy (fURS)

• Retrograde intrarenal surgery (RIRS)

• Percutaneous nephrolithotomy (PCNL)

are now considered standard of care according to the American Urological Association (AUA) and the European Association of Urology (EAU).

Within these procedures, one instrument plays a critical role in achieving high stone-free rates: the stone retrieval basket.

This article provides a structured, evidence-based explanation of:

• Types of stone baskets

• Surgery-specific basket selection

• The most commonly used basket in the United States

• Clinical rationale supported by official guidelines

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Surgical Management of Kidney Stones 

American Urological Association (AUA)

The AUA Surgical Management of Stones Guideline recommends flexible ureteroscopy for many renal and ureteral stones ≤ 2 cm. It also recognizes the routine use of stone extraction devices to improve procedural success after laser lithotripsy.

Official AUA Guideline:
https://www.auanet.org/guidelines/kidney-stones-surgical-management-guideline

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European Association of Urology (EAU)

The EAU Guidelines on Urolithiasis support:

• Flexible ureteroscopy for intrarenal stones

• Use of atraumatic extraction techniques

• Endoscopic retrieval devices to reduce ureteral injury risk

Official EAU Guideline:
https://uroweb.org/guidelines/urolithiasis

These authoritative recommendations reinforce the clinical importance of stone baskets in modern endourology.

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What Is a Stone Basket?

A stone basket is a flexible wire-based retrieval device passed through the working channel of a ureteroscope or nephroscope to:

• Capture stones

• Retrieve laser-fragmented debris

• Reposition calculi within the urinary tract

Its purpose is to safely achieve a stone-free outcome while minimizing ureteral trauma.

Clinical discussions on basket performance and endoscopic techniques are available through the National Library of Medicine (PubMed):

https://pubmed.ncbi.nlm.nih.gov

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Comprehensive Classification of Stone Baskets

Stone baskets can be categorized in several clinically relevant ways.

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1. Based on Wire Configuration

• Single-wire basket

• Two-wire basket

• Three-wire basket

• Four-wire basket (most widely adopted configuration)

• Six-wire basket

• Eight-wire basket

• Flat-wire basket

• Variable-geometry basket

• Expandable basket

Among these, the four-wire design offers a practical balance between flexibility and secure stone capture, which explains its widespread use in flexible ureteroscopy.

Peer-reviewed technical discussions are searchable via PubMed:
https://pubmed.ncbi.nlm.nih.gov

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2. Based on Tip Design

The EAU guidelines emphasize minimizing ureteral trauma during stone extraction, which supports the growing preference for atraumatic and tipless designs.

EAU Reference:
https://uroweb.org/guidelines/urolithiasis

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3. Based on Material

The mechanical advantages of nitinol—including flexibility and memory shape recovery—are well documented in urological device literature indexed in PubMed.

NIH Database:
https://pubmed.ncbi.nlm.nih.gov

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Which Stone Basket Is Most Used in the United States?

The Tipless Nitinol 4-Wire Stone Retrieval Basket

Based on current surgical practice patterns and guideline-supported techniques, the Tipless Nitinol 4-Wire basket is the most commonly used stone basket in the United States.

Its dominance is explained by four major factors:

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1. Growth of Flexible Ureteroscopy

Flexible ureteroscopy has significantly increased over the past decade and is frequently performed in outpatient settings.

Procedure utilization data can be reviewed via:
Centers for Medicare & Medicaid Services (CMS)
https://data.cms.gov

The AUA guideline confirms flexible ureteroscopy as a recommended approach for many stones ≤ 2 cm.

AUA Reference:
https://www.auanet.org/guidelines/kidney-stones-surgical-management-guideline

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2. Advantages of Nitinol Material

Nitinol offers:

• Superior flexibility

• Resistance to permanent deformation

• Preservation of ureteroscope deflection

• Reliable repeated deployment

These features are particularly important in accessing lower pole calyces during intrarenal surgery.

Scientific literature searchable via:
https://pubmed.ncbi.nlm.nih.gov

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3. Safety Benefits of Tipless Design

Tipless baskets:

• Reduce risk of ureteral perforation

• Minimize mucosal abrasion

• Improve intrarenal maneuverability

The EAU emphasizes atraumatic techniques to reduce ureteral complications.

EAU Guideline:
https://uroweb.org/guidelines/urolithiasis

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4. Four-Wire Configuration Provides Optimal Balance

The four-wire structure offers:

• Secure fragment capture

• Adequate expansion

• Maintained flexibility

This balance makes it suitable for the majority of flexible ureteroscopy procedures performed in the U.S.

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Surgery-Specific Basket Selection

 

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Frequently Asked Questions (FAQ)

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1. What is the most commonly used stone basket in the USA?

The Tipless Nitinol 4-Wire stone retrieval basket is most commonly used, particularly in flexible ureteroscopy procedures.

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2. Why is nitinol preferred over stainless steel?

Nitinol provides superior elasticity and shape memory, allowing better maneuverability and reduced scope deflection loss.

Scientific Evidence:
National Library of Medicine (NIH)
https://pubmed.ncbi.nlm.nih.gov

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3. Are tipless baskets safer?

Yes. Atraumatic designs reduce the risk of ureteral injury, which aligns with EAU guideline recommendations.

EAU Reference:
https://uroweb.org/guidelines/urolithiasis

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4. Which basket is used in PCNL?

PCNL procedures typically use larger, stronger baskets designed for fragment retrieval through a percutaneous tract.

EAU PCNL Guidance:
https://uroweb.org/guidelines/urolithiasis

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5. Where can official kidney stone statistics be found?

U.S. government data is available through the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK):

https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones

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Conclusion

To help equip your practice with clinically versatile and atraumatic designs, explore a range of nitinol stone baskets tailored for different procedural needs:

👉 Browse high-performance stone baskets for ureteroscopy and RIRS at:
🔗 https://minervahealthinc.com/search?type=product&q=Stone+basket 

Whether you need tipless baskets for intrarenal work, tipped designs for targeted capture, or hybrid grasper–basket options to streamline workflow, there’s a solution to support evidence-based practice.