Category: Clinical Stones: PCNL

MP5-22 - Use of a novel device 'Endocone' for prevention of stone migration during PCNL

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

Introduction & Objective : To assess the safety and efficacy of using a novel device "Endocone" for prevention of stone migration during PCNL.


Methods :

Prospectively from January 2014 to February 2017 after local Ethical Committee approval and obtainment of informed consent from 32 patients with solitary kidney stones  ≥ 2 cm the results of modified standard percutaneous nephrolithotomy with the use of a novel device "Endocone" were analyzed. After gaining percutaneous access and evaluating the collecting system "Endocone" device was prepared in the operating room from the polypropylene mesh by the surgeon himself  (Fig 1).  With the backloading of the "Endocone» to the bi-pronge forceps the later was inserted into the infundibulum of the calyx where stone fragments could migrate during nephrolithotripsy (Fig 2). Data on patient demographics, stone criteria, duration of operation, the time needed to prepare "Endocone", hemoglobin drop and SFR were analysed and reported.


Results : The mean stone diameter was 20 25 32 mm  and mean duration of operation was 34 58 73 minutes. The use of the "Endocone" did increase the operative duration only by 3 5 8 minuntes, needed for preparation of the single device but the stone free rate, confirmed by low-dose computed totmography 24 hours after operation was 96%.  The way "Endocone" works is shown on the following photo (Fig 3). Mean postoperative hemoglobin change was 101.3 22 g/dL and no patient required a hemotransfusion. 





 






Conclusions : The "Endocone" is a novel device aimed at prevention of stone migration during PCNL which is both safe and effective in highly selected cases.

Nariman Gadzhiev

Endourologist
Pavlov First Saint Petersburg State Medical University/Nikiforov Russian Center of Emergency and Radiation Medicine
Saint-Petersburg, Leningrad, Russia

Nariman Gadzhiev, MD
Endourology fellow in "The Nikiforov Russian Center of Emergency and Radiation Medicine", Saint-Peterburg, Russia
Endourologist in The Pavlov’s First State Medical University, Saint-Petersburg, Russia

Vladimir Obidnyak

Urologist
"Saint Luka" Clinical Hospita
Saint-Petersburg, Leningrad, Russia

Aleksei Pisarev

Urologist
St Petersburg Multiprofile Center
Saint-Petersburg, Leningrad, Russia

Dmitry Gorelov

Urologist
Pavlov First Saint Petersburg State Medical University
Saint-Petersburg, Leningrad, Russia

Sergei Petrov

Head of urological department
Nikiforov Russian Center of Emergency and Radiation Medicine
Saint-Petersburg, Leningrad, Russia