Category: Clinical Stones: Ureteroscopy
Introduction & Objective : We aimed to report the force of insertion (FOI) applied by an endourologist while inserting UAS with and without JJ stent in 6patients undergoing retrograde intrarenal surgery for stone treatment.
Methods : A digital force gauge was connected to the distal shaft of the UAS. The FOI was continuously recorded during the placement (Picture 1). Four patients (Patient 2, 3, 5 and 6) had a JJ stent before the procedure whereas two had not (Patient 1 and 4). A 10-12 Fr UAS was used for patient 1 and 4, an 11-13 Fr was used for patient 2 and 12-14 UAS was used for the pre-stented Pt 3, 5 and 6. All 6 patients were diagnosed with kidney stones and all were female. The 10-12 Fr UAS used for the patient 4 was on its 4th use after re-sterilization.
Results : The insertion was successful in all patients, except patient 4. The failure of insertion was on patient without prior JJ stent where a re-sterilized 10-12 Fr UAS was used. The UAS size, presence of JJ, insertion time, max and average FOI are shown on the table. The average, max FOI and time of the successful insertions was 1.26±0.5 N, 2.45±0.95 and 10.8±2.34 sec, respectively. The FOI ofthe unsuccessful insertion had a 3.92 N max load in 8 sec. Picture 2 shows the FOI graphics of the patient 1 and 4 with UAS 10-12 Fr.
Conclusions : The FOI of UASs is lower in pre-stented patients even with larger UAS diameters. Re sterilization of UAS should not be advocated.
Tzevat Tefik– Associate Professor of Urology, Istanbul University Istanbul Faculty of Medicine, Istanbul, Istanbul, Turkey
Salvatore Buttice– Agrigento, Sicilia, Italy
Bhaskar Somani– Consultant Urologist, Associate Professor, University Hospital Southampton , U.K, Southampton, England, United Kingdom
Haluk Ander– Istanbul, Istanbul, Turkey
Selcuk Erdem– Academic Staff (Urologist), Department of Urology Istanbul University, Istanbul Faculty of Medicine, Fatih, Istanbul, Turkey
Samed Verep– Istanbul, Istanbul, Turkey
Faruk Ozcan– Istanbul, Istanbul, Turkey
Taner Kocak– Istanbul, Istanbul, Turkey
Ismet Nane– Istanbul, Istanbul, Turkey
Olivier Traxer– Professor, Sorbonne Universite, GRC n020 Lithiase Renale, AP-HP, Hospital Tenon, F-75020 Paris, France, Paris, Ile-de-France, France
Associate Professor of Urology
Istanbul University Istanbul Faculty of Medicine
Istanbul, Istanbul, Turkey
Tzevat Tefik studied Medicine at Istanbul University, Cerrahpaşa Faculty of Medicine, English Department (1997-2004) and then he finished his Urology training (2005-2011) at Istanbul University, Istanbul Faculty of Medicine. He did a short fellowship in Tenon Hospital (2015) with Professor Olivier Traxer.
Tzevat has published more than 35 peer-reviewed articles and over 140 published abstracts/presentations in National/International meetings. These cover a broad range of topics in Endourology, Renal Transplantation, Oncology, Laparoscopy and Paediatric Urology.
Consultant Urologist, Associate Professor
University Hospital Southampton , U.K
Southampton, England, United Kingdom
Bhaskar is an Endourologist and Associate Professor in Southampton, and is an active member of European School of Urology 'Training and Research group' and ESUT Endourology group. He has been teaching on EUREP hands-on-training for the last 5 years and is the senior author in the new ‘Endoscopic stone treatment (EST)’ curriculum established for training and examinations. He has performed live surgery in EAU with presentations and moderations in EULIS, WCE and SIU. He is also a member of EAU ‘Train the Trainer’ committee.
He is research active and has published more than 200 papers with over 300 published abstracts/presentations. He is on the editorial board of 3 journals, a reviewer for 14 journals and Investigator for 5 trials. He sits on the MCQ panel for FRCS examinations and is a ‘Specialist advisor’ to National Institute of Clinical Excellence (NICE) Interventional procedures and ‘Invited expert’ to NICE urological infections. He is an elected member of BAUS Academic section and was recently selected as a Fellow of Faculty of Surgical Trainers.
Academic Staff (Urologist)
Department of Urology Istanbul University, Istanbul Faculty of Medicine
Fatih, Istanbul, Turkey
Selcuk Erdem, MD, Fellow of European Board of Urology (FEBU)
Department of Urology, Istanbul University Istanbul Faculty of Medicine