PMID- 17941796
OWN - NLM
STAT- MEDLINE
DCOM- 20080123
LR  - 20161018
IS  - 0892-7790 (Print)
IS  - 0892-7790 (Linking)
VI  - 21
IP  - 9
DP  - 2007 Sep
TI  - A newly designed amplatz sheath decreases intrapelvic irrigation pressure during 
      mini-percutaneous nephrolitholapaxy: an in-vitro pressure-measurement and 
      microscopic study.
PG  - 1113-6
AB  - BACKGROUND AND PURPOSE: In recent years, mini-percutaneous nephrolitholapaxy 
      (mini-PCNL) has gained popularity because of its reduced invasiveness. To improve 
      clinical outcomes further, research is ongoing in selected centers. Important 
      areas of interest include extravasation into the retroperitoneal space, acute 
      absorption syndrome, and septicemia. The aim of this experimental study was to 
      test a new 18F nephroscope sheath specially designed to decrease intrapelvic 
      pressure during mini-PCNL whatever the irrigation pressure. In addition, the 
      hydrodynamic effects of this device can be used for suction and removal of the 
      stone fragments, in contrast to a standard Amplatz sheath. MATERIALS AND METHODS: 
      In a fresh, perfused cadaveric porcine kidney model, the new sheath was compared 
      with a conventional sheath (control) with closed and open Luer-Lok outflow under 
      increasing irrigation pressure. Intrarenal pressure peaks were measured with a 
      urodynamic workstation. The irrigation fluid was marked with an ink that stains 
      only endoluminal surfaces, and a post-measurement histopathologic work-up was 
      performed to evaluate the changes on a morphologic level. RESULTS: Closing of the 
      control sheath resulted in an increase in the intrapelvic pressure to a maximum 
      of 136 cm H2O. Using the new sheath with a constant output flow made possible by 
      its open proximal end, the maximal intrapelvic pressure remained low at 20 cm 
      H2O, even when the inflow pressure reached 125 cm H2O. The ink distribution on 
      the hematoxylin and eosin-stained slides reflected the results of the pressure 
      measurements. CONCLUSIONS: Newly designed nephroscope sheaths with an open 
      proximal end, such as the one described here, decrease the intrapelvic pressure 
      compared with a closed outflow system. As a result, strict fluid control during 
      the intervention is not necessary.
FAU - Nagele, Udo
AU  - Nagele U
AD  - Department of Urology, University of Tuebingen, Tuebingen, Germany. 
      Udo.Nagele@med.uni-tuebingen.de
FAU - Horstmann, Marcus
AU  - Horstmann M
FAU - Sievert, Karl-Dietrich
AU  - Sievert KD
FAU - Kuczyk, Markus A
AU  - Kuczyk MA
FAU - Walcher, Ute
AU  - Walcher U
FAU - Hennenlotter, Jorg
AU  - Hennenlotter J
FAU - Stenzl, Arnulf
AU  - Stenzl A
FAU - Anastasiadis, Aristotelis G
AU  - Anastasiadis AG
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Endourol
JT  - Journal of endourology
JID - 8807503
RN  - 0 (Fluorine Radioisotopes)
RN  - 059QF0KO0R (Water)
SB  - IM
MH  - Animals
MH  - Equipment Design
MH  - Fluorine Radioisotopes/chemistry
MH  - Kidney/metabolism
MH  - Microscopy/methods
MH  - Nephrostomy, Percutaneous/*instrumentation/*methods
MH  - Pressure
MH  - Swine
MH  - Therapeutic Irrigation/*instrumentation/*methods
MH  - Treatment Outcome
MH  - Urologic Surgical Procedures/*instrumentation/methods
MH  - Water/chemistry
EDAT- 2007/10/19 09:00
MHDA- 2008/01/24 09:00
CRDT- 2007/10/19 09:00
PHST- 2007/10/19 09:00 [pubmed]
PHST- 2008/01/24 09:00 [medline]
PHST- 2007/10/19 09:00 [entrez]
AID - 10.1089/end.2006.0230 [doi]
PST - ppublish
SO  - J Endourol. 2007 Sep;21(9):1113-6. doi: 10.1089/end.2006.0230.