Category: Stones: Ureteroscopy
Introduction & Objective : We present a video abstract demonstrating our clinical application of intraoperative transabdominal ultrasound guidance for ureteroscopic treatment of renal stones. This preliminary work serves to demonstrate that live ultrasound image guidance during ureteroscopic work is achievable with novice users, which may have implications for reducing use of fluoroscopy and radiation exposure.
Methods : Two PGY2 urologic surgical residents were trained in the basics of ultrasound imaging for the purposes of gudiding ureteroscopic laser lithotripsy in patients undergoing renal stone placement at a single institution.
Results : Our video abstract demonstrates examples of detecting of renal stones, guidewire deployment, localization of the ureteroscope in various renal calicies and live visualization of laser lithotripsy. Furthurmore, we detect extravesation of fluid from the renal pelvis detected during the procedure and resolution of extravesation with stent placement. Ultrasonographic findings are correlated with intraoperative fluoroscopy.
Conclusions : Intraoperative ultrasonographic guidance for ureteroscopy can provide useful live imaging with the potential advantage of minimizing radiation exposure to patients and urologists.
Assistant Professor of Surgery
Massachusetts General Hosptial and Harvard Medical School