Category: Stones: PCNL

VS2-5 - Clinical experience with suction- evacuation sheath (ClearPetra ®) in mini-percutaneous nephrolithotomy.

Fri, Sep 21
10:00 AM - 12:00 PM

Introduction & Objective :

Use of evacuation sheath with negative pressure suction is postulated as a good alternative to traditional access sheaths in endourological surgery for stones treatment.


The objective of this video is to present a summary of 3 mini percutaneous renal surgeries using this device performed in our centre during 2017 and a review of the peculiarities and advantages of ClearPetra®from a practical point of view.


Methods :

In the video, we present 3 clinical cases of patients that underwent mini-percutaneous nephrolithotomy (mini-PCNL) in our institution. For all the surgeries, a 16 f suction evacuation sheath was employed for the resolution of intrarenal radiopaque stones.


Two of the patients were women aged 66 and 34 and the other patient was a 47 years old man. The stone localization in all the three cases was left with an average size of 25,30 and 35 mm respectively.


Likewise, we perform a documented analysis of principal advantages of using this device such as: reduction of intraluminal pressure, decrease in the retropulsion during laser fragmentation, improvement of vision during surgery, possibility of treating larger volume stones and economization in the use of tools for fragment extraction.


Results :

During surgeries, there was no need in any of the cases for using extra material for stone fragment extraction.


Patients had a good clinical evolution after surgery. Only one of the patients presented a Clavien 2 complication with profuse bleeding after surgery that required blood transfusion. This remains us that this technique is not exempt of morbidity despite providing important advantages.


Stone was resolved partially in all 3 cases, they all required an external shock wave lithotripsy for complete stone resolution.


 


Conclusions :

The incorporation of new suction-evacuation sheaths supposes an advantage to optimize and ameliorate the results of minipercutaneous intrarenal surgery. 


This can potentially ameliorate the outcomes of this surgical technique.


 

Maria Rodriguez-Monsalve Herrero

Urologist
University Hospital Puerta de Hierro, Majadahonda.
Majadahonda, Madrid, Spain

Javier Sáenz-Medina

University Hospital Puerta de Hierro, Majadahonda.
Madrid, Madrid, Spain

Esau Fernández Pascual

University Hospital Puerta de Hierro, Majadahonda.
Madrid, Madrid, Spain

Elena García Criado

Madrid, Madrid, Spain

Joaquin Carballido Rodriguez

Madrid, Madrid, Spain