The “All-Seeing Needle”: Initial Results of an Optical Puncture System Confirming Access in Percutaneous Nephrolithotomy

Bader, Markus; Gratzke, Christian; Seitz, Michael; Sharma, Rajan; Stief, Christian G.; Desai, Mahesh

doi:10.1016/j.eururo.2011.03.026

Cited by 171 publications

(109 citation statements)

References 25 publications

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“…Aside from medical imaging, several approaches have been reported in order to easily track and guide the needle tip inside the kidney, in particular the exploration of different patient positions 12,13,24 , robotic assisted surgeries 15 , navigation systems [17][18][19] and electronically instrumented needles 2,19 .…”

Section: Discussionmentioning

confidence: 99%

“…Although fluoroscopy and ultrasounds are the most popular approaches 2 , modifying surgery 9, 10 and patient position [11][12][13] , use of computed tomography 14 , robotic devices 15,16 , and navigation systems [17][18][19] have been proposed to improve and ease the renal puncture during PCNL. However, most of these tools and techniques only assure 2D images, do not provide real-time 3D information, demand preprocessing steps to register all the anatomical structures, are not tested in vivo and may also be affected by operator skill, patient breath movement, and needle deflection 2,17,20 .…”

Section: Introductionmentioning

confidence: 99%

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Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

et al. 2013

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DISCLAIMER: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our subscribers we are providing this early version of the article. The paper will be copy edited and typeset, and proof will be reviewed before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to The Journal pertain.All press releases and the articles they feature are under strict embargo until uncorrected proof of the article becomes available online. We will provide journalists and editors with full-text copies of the articles in question prior to the embargo date so that stories can be adequately researched and written. The standard embargo time is 12:01 AM ET on that date. Materials and Methods:Six anesthetized female pigs underwent ureterorenoscopies in order to place a catheter with an EMT sensor into the desired puncture site and to ascertain the success of puncture. Subsequently, a tracked needle with a similar EMT sensor was navigated into the sensor inside the catheter. Four punctures were performed by two surgeons in each pig: one in the kidney and one in the middle ureter, on both right and left pig sides. Number of attempts and time needed to evaluate the virtual trajectory and to perform the percutaneous puncture were outcomes measurements. Results:Overall 24 punctures were easily performed without any complications.Surgeons required more time to evaluate the trajectory during ureteral puncture than kidney (median 15 versus 13 seconds, range 14 to 18 and 11 to 16 seconds, respectively; p= 0.1). The median renal and ureteral puncture time were 19 and 51 seconds respectively (range 14 to 45 and 45 to 67; p=0.003). Two attempts were needed to achieve a successful ureteral puncture. The presented technique demands presence of renal stone for testing. Conclusions:The proposed EMT solution for renal collecting system puncture proved to be highly accurate, simple and quicker. This method might represent a paradigm shift in percutaneous kidney access techniques.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

et al. 2013

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“…Son yıllarda optik teknolojisindeki gelişmeler ışığında, Bader ve arkadaşları 2011 yılında literatürdeki en küçük çaplı (12). 0.9 mm çapındaki 10.000 piksellik görüntü sağlayan esnek optik 16G (4.85Fr) kalınlığında bir iğne içinden geçirilerek PNL işlemi için güvenli bir perkütan renal akses oluşturmak için kullanıldı.…”

Section: Mikroperk'in Gelişim Süreci Ve İlgili Klinik çAlışmaların Sounclassified

Mikroperk

Armağan¹

2015

Endouroloji

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“…In the following years, Jackman et al used this technique in adult patients (3). Recently published studies underlined that complications like bleeding have declined along with the use of smaller renal access sheaths (4,5). In a prospective randomized study, the authors suggested that while miniperc and conventional PNL had similar stone clearance rates, complication rate was significantly lower in the miniperc group (6).…”

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confidence: 96%

Comparison of efficacy of laser lithotripter with ultrasonic lithotripter in mini percutaneous nephrolithotomy

Akbulut

Küçüktopçu

Kandemir

et al. 2016

Arch Ital Urol Androl

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Objective: The aim of the study was to compare the efficacy of the laser lithotripter with the ultrasonic lithotripter in mini percutaneous nephrolithotomy (miniperc). Material and Methods: From June 2013 to January 2014; medical records of 77 consecutive patients who underwent miniperc operation were retrospectively evaluated. Ultrasonic lithotripter was used in 22 patients (Group 1), while laser was used in 55 patients. In the laser group, 22 patients were randomly selected who had same characteristics compared to group 1 (Group 2). Success rate, total operative time, complications according to modified Clavien classification, fluoroscopy time, haemoglobin drop, hospital stays and cost analysis were assessed. Success rates were evaluated on the second postoperative day and after the first month. Results: Total operative time (p = 0.635) and fluoroscopy time (p = 0.248) were not significantly different between the two groups. In the laser group, the success rate (81.8%) was notably more than in the ultrasonic lithotripter group (68.2%) but there was no statistically significance (p = 0.296). Ten reusable ultrasonic probe were used for 22 patients, due to thinness and sensitiveness of the probe. Conversely, one single laser fiber (550 micron) was used for 22 patients. When the cost analysis of lithotripsy was considered, the cost per case was 190 dollar in group 1 and 124 dollar in group 2. (p = 0.154) Complication rate, hospital stay and haemoglobin drop were similar in both groups. Conclusion: Laser lithotripsy seems to be more cost effective than ultrasonic lithotripsy for miniperc but larger number of patients are required to confirm this estimation. SummaryNo conflict of interest declared. tion (2). In the following years, Jackman et al. used this technique in adult patients (3). Recently published studies underlined that complications like bleeding have declined along with the use of smaller renal access sheaths (4, 5). In a prospective randomized study, the authors suggested that while miniperc and conventional PNL had similar stone clearance rates, complication rate was significantly lower in the miniperc group (6). In the miniperc series, the lithotripter choice is important for stone fragmentation. Laser, pneumatic, and ultrasonic lithotripters are available fragmentation methods for PNL. While pneumatic lithotripsy is the most common technique used for kidney or ureteral stones, stone retropulsion and migration rate is clearly higher compared with other devices. Ganeasomoni et al. compared laser and pneumatic lithotripsy with miniperc and observed that laser lithotripsy group had a lower stone migration rate (7). The ultrasonic lithotripsy enables simultaneous stone fragmentation and aspiration. Low retropulsion rate and absence of the need of stone retrieval are the main advantages of ultrasonic lithotripsy. However, to the best of our knowledge, there is no published study evaluating the efficacy of the ultrasonic lithotripter with miniperc. In this study, we aimed to compare laser lithotripter an...

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The “All-Seeing Needle”: Initial Results of an Optical Puncture System Confirming Access in Percutaneous Nephrolithotomy

Cited by 171 publications

References 25 publications

Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

Collecting System Percutaneous Access Using Real-Time Tracking Sensors: First Pig Model In Vivo Experience

Mikroperk

Comparison of efficacy of laser lithotripter with ultrasonic lithotripter in mini percutaneous nephrolithotomy

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