Advanced Ureteroscopy: Wireless and Sheathless

Johnson, G. Blake; Portela, Damian; Grasso, Michael

doi:10.1089/end.2006.20.552

Cited by 114 publications

(56 citation statements)

References 13 publications

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“…RIRS, however, is the first-line treatment for patients with bleeding disorders. Johnson et al [17], in their RIRS series with 1,000 cases, proclaim a 95% stone-free rate in stones even bigger than 2 cm. Even with this less invasive procedure, there is a 1% major complication rate [18].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

et al. 2013

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Objective: To compare the results of percutaneous nephrolithotomy (PCNL), shock wave lithotripsy (SWL), and retrograde intrarenal surgery (RIRS) for 1- to 2-cm lower pole kidney stones. Patients and Methods: This retrospective study was based on data collected from the files of patients between January 2007 and May 2012. The files of 383 patients (221 SWL, 144 PCNL, 38 RIRS) were evaluated. The groups were compared for stone size, success rate, and complication rate using the modified Clavien grading system. Results: The stone burdens of the groups were similar (p = 0.36). The success rates were 76, 94, and 73%, respectively, in SWL, PCNL, and RIRS. The highest stone-free rate was in the PNL group (p < 0.05). When the complication rates were evaluated using the Clavien grading system, they were determined to be 13% in PCNL, 3% in SWL, and 5% in RIRS. Especially GII and GIII complications were more common in the PCNL group (p < 0.05). Conclusion: PCNL seems to be the most successful but most invasive method. However, with relatively low complication rates, SWL and RIRS are other techniques to keep in mind. To determine the first-line treatment, prospective randomized studies with larger series are needed.

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Section: Discussionmentioning

confidence: 99%

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

et al. 2013

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“…5,9,12 Moreover, many publications have described their successful experience with both semi-rigid and flexible URS for the treatment of both ureteral and renal stones without the use of an SGW. 5,6,[9][10][11][12] The idea of historical longstanding dogma of "SGW always in endourology" may have come from a time when the ureteroscopes, lithotripsy equipment and disposable materials were under development. Nowadays, small digital flexible ureteroscopes with 270 degrees of deflection, small laser fibers, hydrophilic ureteral access sheaths, hybrid guide-wires and nitinol baskets have raised the safety and precision of the procedure to a new level.…”

Section: Discussionmentioning

confidence: 99%

“…Four of them were retrospective observational non-comparative studies (level of evidence 4) 6,9-11 and two were retrospective observational non-consecutive comparative studies (level of evidence 3b). 4,11 Johnson et al 10 studied retrospectively a single-surgeon prospective database of flexible URS. A total of 186 patients were submitted to wireless flexible URS for the treatment of intrarenal stones.…”

Section: Methodsmentioning

confidence: 99%

“…Minor complications were limited to postoperative pyelonephritis in five individuals and gross hematuria in three, both treated successfully with antibiotics and with conservative measures, respectively. 10 Dickstein et al 6 reported their experience with flexible URS for the treatment of ureteropelvic junction (54) and renal calyces (216) stones in 270 consecutive patients. In all cases, lithotripsy was performed with a Holmium:YAG laser until calculi pulverization, without the use of a basket for extraction of fragments.…”

Section: Methodsmentioning

confidence: 99%

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Is a safety guidewire needed for retrograde ureteroscopy?

Molina

Pessôa

Silva

et al. 2017

Rev. Assoc. Med. Bras.

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Introduction:It is generally advised to have a safety guidewire (SGW) present during ureteroscopy (URS) to manage possible complications. However, it increases the strenght needed to insert and retract the endoscope during the procedure, and, currently, there is a lack of solid data supporting the need for SGW in all procedures. We reviewed the literature about SGW utilization during URS. Method: A review of the literature was conducted through April 2017 using PubMed, Ovid, and The Cochrane Library databases to identify relevant studies. The primary outcome was to report stone-free rates, feasibility, contraindications to and complications of performing intrarenal retrograde flexible and semi-rigid URS without the use of a SGW. Results: Six studies were identified and selected for this review, and overall they included 1,886 patients where either semi-rigid or flexible URS was performed without the use of a SGW for the treatment of urinary calculi disease. Only one study reported stone-free rates with or without SGW at 77.1 and 85.9%, respectively (p=0.001). None of the studies showed increased rates of complications in the absence of SGW and one of them showed more post-endoscopic ureteral stenosis whenever SGW was routinely used. All studies recommended utilization of SGW in complicated cases, such as ureteral stones associated with significant edema, ureteral stricture, abnormal anatomy or difficult visualization. Conclusion: Our review showed a lack of relevant data supporting the use of SGW during retrograde URS. A well-designed prospective randomized trial is in order.

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“…Although trauma from the guidewire does not give any false-positive fluorescence within the UUT, bleeding can disturb blue light visualisation, hence a wireless technique is used to insert the flexible ureteroscope [15]. We do not use an access sheath unless navigation of flexible ureterorenoscope is difficult.…”

Section: Techniquementioning

confidence: 99%

Photodynamic Diagnostic Ureterorenoscopy with Orally Administered 5-Aminolaevulinic Acid as Photosensitiser: How I Do It

Kata

Nabi²,

Eljamel³

et al. 2014

Urol Int

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Objective: To explain our use of photodynamic diagnostic ureterorenoscopy, we provide a detailed description of the choice of photosensitiser, equipment needed, a safety profile, and pointers on our technique. Technique: Patients are given oral 5-aminolaevulinic acid (5-ALA) as a photosensitiser 3-4 h pre-operatively, and by using a Xenon blue light source, an eyepiece which blocks light below 450 nm which is fitted onto the ureterorenoscope, we are able to conduct a thorough photodiagnosis of the upper urinary tract. Conclusion: Our technique of photodynamic diagnostic ureterorenoscopy has shown that the sensitivity, specificity and detection rates of upper urinary tract lesions can be significantly increased with the use of oral 5-ALA. Therefore, we provide a detailed explanation of the use of oral 5-ALA photosensitiser, indications and contraindications of the technique in addition to equipment used and potential complications of the procedures.

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Advanced Ureteroscopy: Wireless and Sheathless

Cited by 114 publications

References 13 publications

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

Comparison of Percutaneous Nephrolithotomy, Shock Wave Lithotripsy, and Retrograde Intrarenal Surgery for Lower Pole Renal Calculi 10-20 mm

Is a safety guidewire needed for retrograde ureteroscopy?

Photodynamic Diagnostic Ureterorenoscopy with Orally Administered 5-Aminolaevulinic Acid as Photosensitiser: How I Do It

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