The impact of siphoning effect on renal pelvis pressure during ureteroscopy using an in vitro kidney and ureter model.

Autor: Kim HJ; Department of Urology, Seoul National University Bundang Hospital, 82 Gumi-ro, 173 Beon-gil, Gumi-ro, Bundang-gu, Seongnam-si, 13620, Gyeonggi-do, South Korea. ndthemd@gmail.com., Louters MM; Department of Urology, McLaren Macomb, Mt. Clemens, MI, USA., Dau JJ; Department of Urology, University of Michigan, Ann Arbor, MI, USA., Hall TL; Department of Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA., Ghani KR; Department of Urology, University of Michigan, Ann Arbor, MI, USA., Roberts WW; Department of Urology, University of Michigan, Ann Arbor, MI, USA.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2024 Jul 16; Vol. 42 (1), pp. 415. Date of Electronic Publication: 2024 Jul 16.
DOI: 10.1007/s00345-024-05120-z
Abstrakt: Purpose: To experimentally measure renal pelvis pressure (P RP ) in an ureteroscopic model when applying a simple hydrodynamic principle, the siphoning effect.
Methods: A 9.5Fr disposable ureteroscope was inserted into a silicone kidney-ureter model with its tip positioned at the renal pelvis. Irrigation was delivered through the ureteroscope at 100 cm above the renal pelvis. A Y-shaped adapter was fitted onto the model's renal pelvis port, accommodating a pressure sensor and a 4 Fr ureteral access catheter (UAC) through each limb. The drainage flowrate through the UAC tip was measured for 60 s each run. The distal tip of the UAC was placed at various heights below or above the center of the renal pelvis to create a siphoning effect. All trials were performed in triplicate for two lengths of 4Fr UACs: 100 cm and 70 cm (modified from 100 cm).
Results: P RP was linearly dependent on the height difference from the center of the renal pelvis to the UAC tip for both tested UAC lengths. In our experimental setting, P RP can be reduced by 10 cmH 2 0 simply by lowering the distal tip of a 4 Fr 70 cm UAC positioned alongside the ureteroscope by 19.7 cm. When using a 4 Fr 100 cm UAC, P RP can drop 10 cmH 2 0 by lowering the distal tip of the UAC 23.3 cm below the level of the renal pelvis.
Conclusion: Implementing the siphoning effect for managing P RP during ureteroscopy could potentially enhance safety and effectiveness.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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