Prevention of Stone Migration with the Accordion During Endoscopic Ureteral Lithotripsy

Pagnani, Christopher; Akkad, M. El; Bagley, Demetrius H.

doi:10.1089/end.2011.0386

Cited by 13 publications

(6 citation statements)

References 17 publications

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“…A randomized prospective trial of 23 patients with distal ureteric calculi found that the device caused significantly less retrograde migration during fragmentation with an impact lithotripter. 15 Wu et al conducted a retrospective review of 235 patients with ureteric calculi treated with and without the Accordion as well as laser lithotripsy. 16 The device did not result in a significant reduction fluoroscopy time or operating time, but did produce a significantly higher stone free rate.…”

Section: Cuaj -Original Researchmentioning

confidence: 99%

Dual usage of a stone basket: Stone capture and retropulsion prevention

Kroczak

Ghiculete

Sowerby

et al. 2018

CUAJ

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Introduction: Stone migration during ureteroscopy (URS) for proximal ureteric calculi is a constant challenge. Several retropulsion prevention devices have been developed in order to optimize URS outcomes. Our technique involves capturing the stone within a four-wire Nitinol stone basket and then preforming laser lithotripsy to dust the stone while it is engaged in the basket. The dusted fragments wash out with the irrigation fluid and once small enough, the remaining stone is removed intact. Methods: A retrospective chart review was preformed of all proximal URS procedures performed with semi-rigid URS for a solitary calculus (2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015)(2016). We compared our new technique introduced in 2010 to URS control procedures that did not use retropulsion prevention techniques or devices. Results: One hundred and forty patients underwent URS for proximal ureteric calculi. Mean stone diameter was 9.3±3.4 mm, with similar impaction rate between both groups (44.1% vs. 43.1% control; p=n/s). The mean surgical procedure time was 53.3±17.9 minutes for the new technique and 65.2±29.2 minutes for the control group (p=0.005). Compared to the new technique, the control group had a higher rate of retropulsion (33.3% vs. 14.7%; p=0.01) and required flexible URS more often to exclude or remove residual fragments (24.1% vs. 59.1%; p=0.001). Using the new technique, stone-free rates were higher (79.1% vs. 69.4%; p=n/s) and there was a lower likelihood of leaving residual fragments both <3 mm and ≥3 mm (p=0.001). Conclusions: Our novel technique results in shorter operative times, lower retropulsion rates, and decreases postoperative residual stone fragments.

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Section: Cuaj -Original Researchmentioning

confidence: 99%

Dual usage of a stone basket: Stone capture and retropulsion prevention

Kroczak

Ghiculete

Sowerby

et al. 2018

CUAJ

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“…shockwave lithotripsy (SWL), flexible ureterorenoscopy (fURS)) with affiliated morbidities and health-care costs have been reported [2, 7, 8]. Novel stone retrieval devices have been introduced to address the problem of accidental stone migration: Stone baskets [9, 10], suction devices [11], balloon catheters [12, 13] guidewire [14–16] and gel-based devices [17, 18] significantly reduced the incidence of stone retropulsion. On the contrary, these devices are associated with additional costs and some of them with a higher risk for ureteral injuries [2].…”

Section: Introductionmentioning

confidence: 99%

The “Guidewire-Coil”-Technique to prevent retrograde stone migration of ureteric calculi during intracorporeal lithothripsy

et al. 2017

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BackgroundStone retropulsion represents a challenge for intracorporeal lithotripsy of ureteral calculi. The consequences are an increased duration and cost of surgery as well as decreased stone-free rates. The use of additional tools to prevent proximal stone migration entails further costs and risks for ureteral injuries. We present the simple technique of using a coil of the routinely used guidewire to prevent stone retropulsion.MethodsWe retrospectively evaluated all patients with mid-to-proximal ureteral stones in 2014, which were treated by ureteroscopic lithotripsy (Ho: YAG and/or pneumatic lithotripsy). The preoperative stone burden was routinely assessed using low dose CT scan (if available) and/or intravenous pyelogram.ResultsThe study population consisted of 55 patients with 61 mid-to-proximal calculi. Twentyseven patients underwent semirigid ureterorenoscopy using the “Guidewire-Coil-Technique”, the second group (n = 28) served as control group using the guidewire as usual. There has been a statistically significant reduction of accidental stone retropulsion (2/27 vs. 8/28, p < 0.05) as well as a decreased use of auxiliary procedures (p < 0.05) compared to the control group. No difference was observed in operative time. One ureteral injury in the control group required a prolonged ureteral stenting.ConclusionThe “Guidewire-Coil-Technique” is a simple and safe procedure that may help to prevent proximal calculus migration and therefore may increase stone-free rates without causing additional costs.

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“…Ursiny M and Eisner BH, studied the cost-effectiveness of the use of stone retropulsion barrier tools during urethroscopic lithotripsy in 2013 at Harvard University and stated that due to the assessment of these tools' costs and the cost of secondary actions due to stone retropulsion, the use of a barrier tool that prevents stone retropulsion during urethroscopic lithotripsy is more than 6.6% cost-effective [13]. although most of this tools have limitations that prevent their routine use during ureteroscopic lithotripsy treatment [19].…”

Section: Discussionmentioning

confidence: 99%

The Efficacy and Safety of Simultaneous Use of Wire Stone Basket and Pneumatic Lithotripter Probe in the Treatment of Ureteral Stones: Randomized Control Trial

Asadi

Nikpoor

Fattahi

2019

JPRI

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Introduction: A routine treatment of ureteral stones is using ureteroscopic lithotripsy, a common problem of which is retropulsion of the stone to the renal pelvis and calyces that reduces the rate of lithotripsy’s success. In this study, we aim to investigate the safety and success of using wire basket to hold the stones along with pneumatic lithotripstic probe in endoscopic lithotripsy of ureteral stones. Methods: Patients with ureteral stone were randomly divided to groups A and B. Group A (control) undergone lithotripsy without basket and group B (case) with wire basket along with pneumatic lithotripsy. In addition to demographic and clinical data, rate of success, retropulsion and residual stone with a size of greater than 3 mm were collected, before, during and after lithotripsy. Additionally, the total duration of lithotripsy and ureteral traumatic side effects was also recorded in both groups. All the patients were followed up until their discharge. Data was analyzed using SPPSS ve. 20. Results: There was no significant difference between groups by the point of demographic data. When compared together, there was no significant difference between the location, side and size of the stone and duration of the lithotripsy in both groups. The rate of lithotripsy success was significantly higher in the case group. The incidence of retropulsion and need for a secondary intervention was significantly higher in the control group. We didn’t have any ureteral trauma in neither control nor case group. Conclusion: Based on the results of this study, using wire basked as an anti retropulsion device increases the stone free rate in addition to it’s easy applicability, So it can be useful in treatment of ureteral stone.

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Prevention of Stone Migration with the Accordion During Endoscopic Ureteral Lithotripsy

Cited by 13 publications

References 17 publications

Dual usage of a stone basket: Stone capture and retropulsion prevention

Dual usage of a stone basket: Stone capture and retropulsion prevention

The “Guidewire-Coil”-Technique to prevent retrograde stone migration of ureteric calculi during intracorporeal lithothripsy

The Efficacy and Safety of Simultaneous Use of Wire Stone Basket and Pneumatic Lithotripter Probe in the Treatment of Ureteral Stones: Randomized Control Trial

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