Silvia Proietti1,2, Laurian Dragos2,3, Bhaskar Somani4, Salvatore Butticè2,5, Michele Talso2,6, Esteban Emiliani2,7, Mohamed Baghdadi2, Guido Giusti1, Olivier Traxer8. 1. Department of Urology, San Raffaele Hospital, Ville Turro Division, Milan, Italy. 2. Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris, Paris, France. 3. Department of Urology, East Surrey Hospital, Surrey and Sussex Healthcare NHS, Redhill, United Kingdom. 4. Urology, University Hospital Southampton NHS Trust, Southampton, United Kingdom. 5. Department of Human Pathology, Unit of Urology, University of Messina, Messina, Italy. 6. Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy. 7. Department of Urology, Fundacion Puigvert Universitat Autonoma de Barcelona, Barcelona, Spain. 8. Department of Urology, GRC Lithiase (Groupe Recherche Clinique), Université Pierre et Marie Curie - Paris VI, Paris, France.
Abstract
Purpose: To evaluate in vitro the maximum pressure generated in an artificial kidney model when people of different levels of strengths used various irrigation systems. Materials and Methods: Fifteen people were enrolled and divided into three groups based on their strengths. Individual strength was evaluated according to the maximum pressure each participant was able to achieve using an Encore™ Inflator. The irrigation systems evaluated were as follows: T-Flow™ Dual Port, Hiline™, continuous flow single action pumping system (SAPS™) with the system close and open, Irri-flo II™, a simple 60-mL syringe, and Peditrol™. Each irrigation system was connected to URF-V2 ureteroscope, which was inserted into an artificial kidney model. Each participant was asked to produce the maximum pressure possible with every irrigation device. Pressure was measured with the working channel (WC) empty, with a laser fiber, and a basket inside. Results: The highest pressure was achieved with the 60 mL-syringe system and the lowest with SAPS continuous version system (with continuous irrigation open), compared to the other irrigation devices (p < 0.0001). Irrespective of the irrigation system, there was a significant difference in the pressure between the WC empty and when occupied with the laser fiber or the basket inside it (p < 0.0001). The stratification between the groups showed that the most powerful group could produce the highest pressure in the kidney model with all the irrigation devices in almost any situation. The exception to this was the T-Flow system, which was the only device where no statistical differences were detected among these groups. Conclusion: The use of irrigation systems can often generate excessive pressure in an artificial kidney model, especially with an unoccupied WC of the ureteroscope. Depending on the strength of force applied, very high pressure can be generated by most irrigation devices irrespective of whether the scope is occupied or not.
Purpose: To evaluate in vitro the maximum pressure generated in an artificial kidney model when people of different levels of strengths used various irrigation systems. Materials and Methods: Fifteen people were enrolled and divided into three groups based on their strengths. Individual strength was evaluated according to the maximum pressure each participant was able to achieve using an Encore™ Inflator. The irrigation systems evaluated were as follows: T-Flow™ Dual Port, Hiline™, continuous flow single action pumping system (SAPS™) with the system close and open, Irri-flo II™, a simple 60-mL syringe, and Peditrol™. Each irrigation system was connected to URF-V2 ureteroscope, which was inserted into an artificial kidney model. Each participant was asked to produce the maximum pressure possible with every irrigation device. Pressure was measured with the working channel (WC) empty, with a laser fiber, and a basket inside. Results: The highest pressure was achieved with the 60 mL-syringe system and the lowest with SAPS continuous version system (with continuous irrigation open), compared to the other irrigation devices (p < 0.0001). Irrespective of the irrigation system, there was a significant difference in the pressure between the WC empty and when occupied with the laser fiber or the basket inside it (p < 0.0001). The stratification between the groups showed that the most powerful group could produce the highest pressure in the kidney model with all the irrigation devices in almost any situation. The exception to this was the T-Flow system, which was the only device where no statistical differences were detected among these groups. Conclusion: The use of irrigation systems can often generate excessive pressure in an artificial kidney model, especially with an unoccupied WC of the ureteroscope. Depending on the strength of force applied, very high pressure can be generated by most irrigation devices irrespective of whether the scope is occupied or not.
Entities:
Keywords:
flexible ureteroscopy; intrarenal pressure; irrigation systems
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
Authors: Laurian B Dragos; Bhaskar K Somani; Etienne X Keller; Vincent M J De Coninck; Maria Rodriguez-Monsalve Herrero; Guido M Kamphuis; Ewa Bres-Niewada; Emre T Sener; Steeve Doizi; Oliver J Wiseman; Olivier Traxer Journal: Transl Androl Urol Date: 2019-09