Effect of outflow resistance on intrarenal pressure at different irrigation rates during ureteroscopy: in vivo evaluation

Marom, Ron; Dau, Julie J; Hall, Timothy L.; Ghani, Khurshid R.; Louters, Marne M.; Kim, Hyung Joon; Khajeh, Nikta Rezakahn; Roberts, William W.

doi:10.1007/s00240-023-01470-2

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Cited by 3 publications

References 31 publications

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Assessing renal tissue temperature changes and perfusion effects during laser activation in an in vivo porcine model

Marom,

Dau,

Ghani

et al. 2024

World J Urol

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Assessing renal tissue temperature changes and perfusion effects during laser activation in an in vivo porcine model

Marom,

Dau,

Ghani

et al. 2024

World J Urol

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Automatic irrigation system with a fiber-optic pressure sensor regulating intrapelvic pressure for flexible ureteroscopy

Yoshida,

Tsuruoka,

Haga

et al. 2023

Sci Rep

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Increased intrapelvic pressure (IPP) due to irrigation during flexible ureteroscopy (f-URS) can pose a risk of postoperative severe urinary tract infection associated with pyelovenous backflow. An automatic regulation system for maintaining safe IPP levels could enable surgeons to perform f-URS safely without postoperative complications. This study aimed to assess the measurement accuracy of an ultra-miniature fiber-optic pressure sensor incorporated into a small-caliper ureteroscope for assessing IPP and to develop an automatic irrigation system linked to this sensor. A porcine kidney was used for the ex vivo experiment. The nephrostomy catheter, connected to the conventional pressure transducer, was placed on the renal pelvis to evaluate the actual IPP (a-IPP). For measuring IPP using the fiber-optic pressure sensor (fo-IPP) built into the f-URS, a diaphragm pressure sensor of Φ250 μm was used. To establish an irrigation system, the optimal proportional–integral–derivative (PID) controller was explored to accurately adjust the irrigation pump flow rate. A high correlation between a-IPP and fo-IPP was confirmed across irrigation pressure values of 60–180 mbar (all, r ≥ 0.7, p < 0.001). When performing bolus irrigation, although fo-IPP showed relatively a higher peak value than a-IPP, the response time of fo-IPP was equivalent to that of a-IPP. After PID parameter optimization, our automatic irrigation system based on fo-IPP smoothly and accurately regulated the intended IPP set in the 5–20 mmHg range without overshooting. We successfully developed and demonstrated an automatic irrigation system regulating IPP based on the PID controller for f-URS, utilizing a fiber-optic pressure sensor. Further research, including in vivo studies, will be needed to assess clinical feasibility.

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Evaluation of Automatic Irrigation System for Regulating Intrapelvic Pressure During Instrument Insertion and Removal for Flexible Ureteroscopy

Tsuruoka,

Yoshida,

Haga

et al. 2024

2024 Ieee Sensors

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Effect of outflow resistance on intrarenal pressure at different irrigation rates during ureteroscopy: in vivo evaluation

Cited by 3 publications

References 31 publications

Assessing renal tissue temperature changes and perfusion effects during laser activation in an in vivo porcine model

Assessing renal tissue temperature changes and perfusion effects during laser activation in an in vivo porcine model

Automatic irrigation system with a fiber-optic pressure sensor regulating intrapelvic pressure for flexible ureteroscopy

Evaluation of Automatic Irrigation System for Regulating Intrapelvic Pressure During Instrument Insertion and Removal for Flexible Ureteroscopy

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