Effect of Active Aspiration and Sheath Location on Intrapelvic Pressure During Miniaturized Percutaneous Nephrolithotomy

Upper urinary tract pressures in endourology: a systematic review of range, variables and implications

“…In human studies, negative mean IRPs (−6.4 ± 3.5 cm H 2 O [60]; −16.3 – 2.7 cmH 2 O [68]) are reported with pressure‐sensing suction, despite brisk irrigation [60]. Continuous suction without intelligent pressure control results in reduced mean IRP compared to controls [30,66], however, IRP readings (26.5 ± 7.9 [36]; 22.6 ± 9.6 [69]) are higher than those reported with the use of pressure‐sensing systems. Despite continuous suction, Lai et al.…”

“…In an in vivo study (18‐Fr mPCNL; gravity irrigation at 60 cm), Gökce et al. observed the lowest mean IRP (17.4 ± 7.6cmH 2 O) with the sheath positioned within the renal pelvis and the nephroscope within the sheath [69]. The highest mean IRP (35.3 ± 11.8 cmH 2 O) occurred with the sheath positioned within a renal calyx and the nephroscope advanced beyond the sheath [69].…”

“…Use of suction varies during PCNL and mPCNL, but predictably reduces IRP [37,66–69,73]. Intermittent suction results in IRP <5 cmH 2 O when applied during standard PCNL in vivo , however, higher IRP readings are regained during irrigation periods [37,73].…”

Surgical Parameters Related to Excessive Intrarenal Pressure during Minimally Invasive Percutaneous Nephrolithotomy in the Supine Position: A Prospective Observational Clinical Study

“…Recently, Gökce et al [ 24 ] reported that active aspiration significantly lowers intrapelvic pressure and keeps it <40 cmH 2 O. During the study, the pressure was measured in the mini-PCNL under supine position for 90 seconds in 4 different settings with respect to the location of the tip of the sheath and nephroscope.…”