Continuous monitoring of intrapelvic pressure during flexible ureteroscopy using a sensor wire: a pilot study

Doizi, Steeve; Letendre, Julien; Cloutier, Jonathan; Ploumidis, Achilles; Traxer, Olivier

doi:10.1007/s00345-020-03216-w

Cited by 56 publications

(56 citation statements)

References 15 publications

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“…The intrarenal pressure applied during surgery can allow bacteria to penetrate the collecting ducts and migrate deeper into the kidney parenchyma. When irrigation is performed with a pressure pump set to 80 cmH 2 O or a gravity-driven irrigation bag, the pressure in the system is constantly increased to 60 cmH 2 O [ 25 ]. Each additional manual maneuver can cause a short-term, but strong pressure rise that boosts the intrarenal reflux.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

Dybowski¹,

Bres-Niewada

Rzeszutko³

et al. 2021

Cent european J Urol

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Introduction Infectious complications are among the most frequent and significant complications in retrograde intrarenal lithotripsy. To date, review articles have covered complications after a ureteroscopy, but not after retrograde intrarenal surgery (RIRS), specifically. Because the complications and risk factors are different for a ureteroscopy and RIRS, we aimed to identify variables related to the occurrence of infectious complications post-RIRS. Material and methods This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement. We included original studies that described 100 or more procedures published in 2014–2021. We extracted data and performed a narrative synthesis to explore and interpret differences between the studies. Results We selected 17 studies for analysis, including 10 from 2019–2021. Infectious complications after RIRS were observed in 2.8–7.5% of patients (mean 7.1%). We found seven independent risk factors associated with infectious complications after RIRS: long operative time, recent history of positive urine culture or urinary tract infection or antibiotic use, pyuria/nitrites, small caliber of ureteral access sheath, struvite stone, high irrigation rate, and comorbidities. Conclusions If an increased rate of infectious complications is found at a RIRS center, countermeasures should include restrictions on operative time and irrigation rate, and consideration of larger access sheaths, especially for patients with abnormal urine results or with struvite stones or with a history of urinary tract infection or co-morbidities.

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Section: Discussionmentioning

confidence: 99%

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

Dybowski¹,

Bres-Niewada

Rzeszutko³

et al. 2021

Cent european J Urol

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“…7 Currently, no approach has been widely used for monitoring IRP in the clinic. Some researchers have tried to measure IRP with miniature pressure sensor wires 9,16 and UAS integrated with sensors. 13 However, these methods have some limitations.…”

Section: Discussionmentioning

confidence: 99%

“…13 However, these methods have some limitations. For example, the sensor wire is too soft and expensive, 9 and besides, they all need to place the sensor in the urinary system of the human body. Hence, we here propose a syringe-based irrigation system with an external pressure sensor to noninvasively estimate the IRP.…”

Section: Discussionmentioning

confidence: 99%

“…5 However, irrigation may cause high intrarenal pressure (IRP), which increases the risk of complications such as pyelorenal backflow and sepsis. [6][7][8] It is recommended that IRP should be kept below the threshold of pyelovenous backflow, 40 cmH 2 O, to avoid complications 9 (like most international literature, we use cmH 2 O as the unit of IRP in this paper). Hence, monitoring IRP is meaningful during FURS.…”

Section: Introductionmentioning

confidence: 99%

“…To monitor IRP in daily FURS, Song et al [13][14][15] developed a novel ureteral access sheath (UAS) with a tip that integrates miniature pressure sensors to directly measure IRP. Doizi et al 9 and Shu et al 16 used a digital pressure sensor wire to monitor IRP. However, these methods suffer from limitations such as the inconvenience of use, high cost of the single-use miniature sensors, and involving instruments that occupy the narrow ureter.…”

Section: Introductionmentioning

confidence: 99%

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An irrigation system for noninvasively estimating intrarenal pressure during flexible ureteroscopy

Shu

Hua

Xie

2021

Robotics Computer Surgery

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Background: High intrarenal pressure (IRP) during flexible ureteroscopy (FURS) may lead to severe complications. Reported methods for measuring IRP are often inconvenient to use, expensive and involve instruments that occupy the narrow ureter. Methods:We proposed an irrigation system, which can noninvasively estimate IRP based on the principle of fluid mechanics. To determine the feasibility of our system, we conducted irrigation experiments on a kidney phantom and a porcine kidney.The estimated IRPs were compared with the ground truth IRPs.Results: When no surgical instrument was inserted into the flexible ureteroscope's working channel, our system can estimate IRP with high accuracy. When a surgical instrument was inserted, our system can approximately estimate the level of IRP.Conclusions: Our proposed irrigation system can noninvasively estimate IRP, presenting a new thought for clinical practice. In future studies, in vivo experiments are needed to further validate and improve the system.

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Safety enhanced surgical robot for flexible ureteroscopy based on force feedback

Shu

Hua

Wang

et al. 2022

Robotics Computer Surgery

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Background: Although some robotic systems have been developed to improve conventional flexible ureteroscopy (FURS), a widely used intervention in urology, these robots rarely have a comprehensive force feedback function which is important for master-slave controlled surgical robots.Methods: Here, we design and fabricate a novel FURS robot with a comprehensive force feedback function. Moreover, to realize better force feedback, a neural network-based method is also demonstrated to estimate the interactive forces between the flexible ureteroscope and the environment. Results:We show that when teleoperating the flexible ureteroscope with our robot, the operator can accurately feel the obstruction if the interactive axial force or torque exceeds 1.2 N or 15.6 mN•m respectively. For bending movement, augmented force feedback greatly improves the accuracy of the operator's perception of obstruction. Conclusions:The developed robotic system with force feedback is expected to improve the safety of robot-assisted FURS.

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Continuous monitoring of intrapelvic pressure during flexible ureteroscopy using a sensor wire: a pilot study

Cited by 56 publications

References 15 publications

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

Risk factors for infectious complications after retrograde intrarenal surgery – a systematic review and narrative synthesis

An irrigation system for noninvasively estimating intrarenal pressure during flexible ureteroscopy

Safety enhanced surgical robot for flexible ureteroscopy based on force feedback

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