Udo Nagele1, Ute Walcher2, Markus Bader3, Thomas Herrmann4, Stephan Kruck5, David Schilling6. 1. Department of Urology and Andrology, General Hospital Hall in Tirol, Milser Str. 10, Hall i.T., 6060, Austria. prof@udonagele.at. 2. Department of Urology and Andrology, General Hospital Hall in Tirol, Milser Str. 10, Hall i.T., 6060, Austria. 3. Community Hospital Ebersberg, Ebersberg, Germany. 4. Hannover Medical School, Hannover, Germany. 5. University Hospital Tübingen, Tübingen, Germany. 6. University Hospital Frankfurt am Main, Frankfurt am Main, Germany.
Abstract
INTRODUCTION: Aim of this study was to investigate whether the combination of high-pressure irrigation inflow combined with simultaneous sensor-controlled suction could improve irrigation turnover without leading to high peak intrarenal pressure in small-calibre percutaneous instruments (SCPI). M + M: A MIP XS sheath (9.5 Fr. outer diameter and 8.5 Fr. inner diameter) and a 7.5-Fr. nephroscope (3-Fr. irrigation channel; MIP XS by Nagele, Karl Storz, Tuttlingen, Germany) was inserted into the collecting system of a non-perfused cadaveric porcine kidney, an 8-Fr. mono-J catheter was introduced through the ureter. Irrigation was performed using a pressure-controlled, combined irrigation/suction pump (Uromat E.A.S.I., Karl Storz, Tuttlingen, Germany) in either single-flow or continuous-flow (=combination of irrigation and suction) mode. Intrarenal pressure was measured and irrigation fluid turnover was measured by a cystometry catheter inserted trans-parenchymally into the renal pelvis. Pressure changes were recorded by a urodynamic workstation. RESULTS: Applying pressure-controlled suction, irrigation fluid turnover could be increased by 5 % at an inflow pressure of 75 mmHg (80-84 ml/min) and 15 % at an inflow pressure of 110 mmHg (196-110 ml/min). Suction decreased the intrarenal pressure by 14 % at 75 mmHg (19-14.5 cm H2O) and 28 % at 110 mmHg inflow pressure (37-26.5 cm H2O). CONCLUSION: Although combination of pressure irrigation with sensor-controlled suction increases irrigation flow in SCPI, the intrarenal pressure could be reduced with combined suction via a transurethral mono-J catheter. This irrigation method in percutaneous surgery is called purging effect.
INTRODUCTION: Aim of this study was to investigate whether the combination of high-pressure irrigation inflow combined with simultaneous sensor-controlled suction could improve irrigation turnover without leading to high peak intrarenal pressure in small-calibre percutaneous instruments (SCPI). M + M: A MIP XS sheath (9.5 Fr. outer diameter and 8.5 Fr. inner diameter) and a 7.5-Fr. nephroscope (3-Fr. irrigation channel; MIP XS by Nagele, Karl Storz, Tuttlingen, Germany) was inserted into the collecting system of a non-perfused cadaveric porcine kidney, an 8-Fr. mono-J catheter was introduced through the ureter. Irrigation was performed using a pressure-controlled, combined irrigation/suction pump (Uromat E.A.S.I., Karl Storz, Tuttlingen, Germany) in either single-flow or continuous-flow (=combination of irrigation and suction) mode. Intrarenal pressure was measured and irrigation fluid turnover was measured by a cystometry catheter inserted trans-parenchymally into the renal pelvis. Pressure changes were recorded by a urodynamic workstation. RESULTS: Applying pressure-controlled suction, irrigation fluid turnover could be increased by 5 % at an inflow pressure of 75 mmHg (80-84 ml/min) and 15 % at an inflow pressure of 110 mmHg (196-110 ml/min). Suction decreased the intrarenal pressure by 14 % at 75 mmHg (19-14.5 cm H2O) and 28 % at 110 mmHg inflow pressure (37-26.5 cm H2O). CONCLUSION: Although combination of pressure irrigation with sensor-controlled suction increases irrigation flow in SCPI, the intrarenal pressure could be reduced with combined suction via a transurethral mono-J catheter. This irrigation method in percutaneous surgery is called purging effect.
Authors: Stephan Kruck; Aristoteles G Anastasiadis; Georgios Gakis; Ute Walcher; Joerg Hennenlotter; Axel S Merseburger; Arnulf Stenzl; Udo Nagele Journal: Urol Res Date: 2011-03-26
Authors: Akito Yamaguchi; Andreas Skolarikos; Niels-Peter Noor Buchholz; Gonzalo Bueno Chomón; Michael Grasso; Pietro Saba; Stephen Nakada; Jean de la Rosette Journal: J Endourol Date: 2011-05-13 Impact factor: 2.942
Authors: R Mager; C Balzereit; K Gust; T Hüsch; T Herrmann; U Nagele; A Haferkamp; D Schilling Journal: World J Urol Date: 2015-09-10 Impact factor: 4.226
Authors: Francis A Jefferson; John M Sung; Luke Limfueco; Sherry Lu; Courtney M Cottone; Shlomi Tapiero; Roshan M Patel; Ralph V Clayman; Jaime Landman Journal: J Endourol Date: 2019-11-20 Impact factor: 2.942