1.2 French stone retrieval baskets further enhance irrigation flow in flexible ureterorenoscopy
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- 作者：Jens Bedke (1) (4)
Ulf Leichtle (2)
Andrea Lorenz (2)
Udo Nagele (3)
Arnulf Stenzl (1)
Stephan Kruck (1) (4) - 关键词：Ureteroscopic surgery ; Miniature instruments ; Stone baskets ; Irrigation flow ; Deflection ; Breaking strength
- 刊名：Urological Research
- 出版年：2013
- 出版时间：April 2013
- 年：2013
- 卷：41
- 期：2
- 页码：153-157
- 全文大小：287KB
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Ulf Leichtle (2)
Andrea Lorenz (2)
Udo Nagele (3)
Arnulf Stenzl (1)
Stephan Kruck (1) (4)
1. Department of Urology, University of Tuebingen, Tuebingen, Germany
4. Department of Urology, Eberhard Karls University Tuebingen, Hoppe-Seyler Strasse 3, 72076, Tuebingen, Germany
2. Department of Orthopaedic Surgery, University of Tuebingen, Tuebingen, Germany
3. Department of Urology, General Hospital Hall i.T, Hall in Tirol, Austria - ISSN：1434-0879
文摘
Ureterorenoscopy (URS) has revolutionized upper urinary tract stone therapy. However, the size of the working channel and the stone baskets limit irrigation flow as well as vision. This study determined further improvements of irrigation flow, deflection capacities and impairments of breaking resistance in a new 1.2 French (F) ultra-miniaturized basket. Irrigation measurements were performed in semirigid URS (semiURS, working channel 5F) and in flexible URS (flexURS, 3.6F) in 0°, 90° and 270° deflection with 1.2F, 1.8F, 1.9F and 2.2F baskets and compared with empty channel. Breaking strength of 1.2F, 1.8F and 1.9F baskets were evaluated using a material testing machine. Tested baskets affected irrigation in semiURS and flexURS (p?<?0.05). Mean?±?SEM (standard error of the mean) for semiURS flow rates counted 197.1?±?2.0, 140.9?±?1.6, 111.1?±?1.5, 98.0?±?1.3 and 77.1?±?0.9?ml/min for empty channel, 1.2F, 1.8F, 1.9F and 2.2F baskets (p?<?0.05). Using unbent flexURS flow rates of 44.2?±?0.4, 20.4?±?0.2, 5.9?±?0.1, 5.4?±?0.1 and 1.5?±?0.1?ml/min for empty channel, 1.2F, 1.8F, 1.9F and 2.2F baskets, were observed (p?<?0.05). The 1.2F versus 2.2F basket showed a 13.6-fold increase in flexURS irrigation (p?<?0.05), while only the 2.2F basket reduced deflection by 20.3?%. The breaking strength decreased with a reduced basket size (1.2F: 6.4?±?0.46 vs. 1.8F: 16.8?±?2.79 vs. 1.9F: 32.2?±?2.74?N, p?<?0.05). Ultra-miniaturized baskets of 1.2F ensured a sufficient irrigation flow as needed for high quality vision in URS stone management. However, miniaturization of the 1.2F basket resulted in a reduced breaking strength compared with larger sized devices which in turn may hamper stone removal by an increased vulnerability.