The Use of Apnea During Ureteroscopy

Emiliani, Esteban; Talso, Michele; Baghdadi, Mohammed; Ghanem, Sadam; Golmard, Jonathan; Pinheiro, Hugo; Gkentzis, Agapios; Butticè, Salvatore; Traxer, Olivier

doi:10.1016/j.urology.2016.06.016

Cited by 32 publications

(21 citation statements)

References 19 publications

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“…As an alternative to the lung ventilation protocol chosen for our study, the use of apneic techniques has been reported. 11 The surgical goal of immobilizing target organ is achieved but there is an important limitation to wide implementation of this technique, compared to the HFJV. The time limit for using apneic oxygenation devices is currently set at 20-30 minutes.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Evaluation of High-Frequency Jet Ventilation in RIRS from a Tertiary Center

Hasan

Brehmer

Harbut

2019

Journal of Endoluminal Endourology

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PurposeRetrograde intrarenal surgery (RIRS) is an effective and safe therapeutic option in the treatment of renal stones&upper tract urothelial carcinoma. High frequency jet ventilation (HFJV) is a lung ventilation mode offering a substantial reduction of renal movement. In our pilot study, we evaluated a HFJV ventilatory protocol in endoscopic treatment of renal stones.Materials and methods15 consecutive cases of the treatment of renal stones larger than 7mm have been included in our study, with exclusion of patients suffering from severe pulmonary disease. Total intravenous anesthesia has been chosen with intraprocedural HFJV. The intraoperative gas exchange parameters, as well as eventual postoperative respiratory adverse events were taken note of. A laser stone disintegration has been performed in all procedures, including a three-month postoperative follow-up.ResultsMean duration of HFJV procedure was 56,3 min (35-110), Et CO2(end tidal ; carbon dioxide concentration measured at the end of expiration,the normal values of which are 4-6%) before HFJV - 4,81 % (4,1-5,8) and after HFJV 5,22 % (3,9-7,2) respectively. No signs of respiratory impairment were detected. The operative time ranged between 20- 102 min. The renal movement reduction with HFJV was of significantly noticeable by the surgeon. Three patients were readmitted to the hospital; one of them due to a urinary tract infection. No perioperative pulmonary complications were reported. ConclusionHFJV is a safe, feasible method that can be used in RIRS and can significantly enhance the efficacy of the procedure. However, further evaluation of the method is needed.

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Section: Discussionmentioning

confidence: 99%

Preliminary Evaluation of High-Frequency Jet Ventilation in RIRS from a Tertiary Center

Hasan

Brehmer

Harbut

2019

Journal of Endoluminal Endourology

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“…A recent report described a protocol to perform apnea during fURS allowing its maintenance for approximately 5 min. This illustrates the role of the collaboration between anesthesiologists and surgeons in order to achieve the treatment [13].…”

Section: The Use Of Apnea During Laser Lithotripsymentioning

confidence: 90%

“…The patient is placed in lithotomy position. Although local, spinal anesthesia and intravenous sedation are feasible options; general anesthesia is suggested because it offers some advantages: renal movement caused by respiration may affect renal navigation and lithotripsy whereas with the mechanical ventilation the use of apnea stops temporarily these issues [11][12][13]. Furthermore, in case of large stone burden the time frame for spinal anesthesia can be exceeded, requiring a second general anesthesia to complete the procedure.…”

Section: Patient Positioning Anesthesiamentioning

confidence: 99%

Flexible ureteroscopy: technique, tips and tricks

Doizi

Traxer

2017

Urolithiasis

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During the last decades, the surgical management of kidney stones benefited of many technological advances and one of them is the development of flexible ureteroscopy (fURS). This tool, ancillary equipment such as graspers and baskets, and lithotripsy technique with Holmium:YAG laser underwent many improvements leading to a widening of its indications with diagnostic and therapeutic management of upper urinary tract pathologies such as urolithiasis and urothelial tumors. The objective of this review is to describe the surgical technique for fURS as well as tips and tricks for the treatment of renal stones.

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“…General anesthesia (GA) is recommended over spinal anesthesia if the patient is suitable, especially for prolonged procedures. GA also provides smaller tidal lung volumes, and therefore, breathing movement is less disruptive to the procedure, and mechanical ventilation can be temporarily stopped if required [ 8 ]. Fluoroscopy equipment should be available in the operating room (OR), and a warning radiation sign and/or a laser sign should be placed outside the OR [ 6 , 7 ].…”

Section: Pre-operative Preparation and Equipmentmentioning

confidence: 99%

Semi-rigid ureteroscopy: indications, tips, and tricks

Whitehurst

Somani

2017

Urolithiasis

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Advances in ureteroscopic technology, alongside broadening treatment options have fuelled the rapid expansion of endourology. Semi-rigid ureteroscopy is a well-known procedure used globally for varying urological conditions, with high success rates. This article aims to provide ‘tips and tricks’ for the semi-rigid ureteroscopy procedure, and the management of commonly encountered pathology such as renal stones, ureteric strictures, and urothelial tumours.

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The Use of Apnea During Ureteroscopy

Cited by 32 publications

References 19 publications

Preliminary Evaluation of High-Frequency Jet Ventilation in RIRS from a Tertiary Center

Preliminary Evaluation of High-Frequency Jet Ventilation in RIRS from a Tertiary Center

Flexible ureteroscopy: technique, tips and tricks

Semi-rigid ureteroscopy: indications, tips, and tricks

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