Ureteral access strategies: Pro-access sheath

Vanlangendonck, Richard; Landman, Jaime

doi:10.1016/s0094-0143(03)00095-8

Cited by 89 publications

(35 citation statements)

References 20 publications

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“…However, a risk of ureteric ischemia after long procedures and ureteric injury during sheath insertion with potential later stricture formation has been postulated. However, several studies have proven the safety of these devices [9,14]. We experienced two ureteric perforations with access sheath, which however were dealt with in a simple and lasting way.…”

Section: Discussionmentioning

confidence: 99%

The New Digital Flexible Ureteroscopes: ‘Size Does Matter’ – Increased Ureteric Access Sheath Use!

et al. 2012

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Objectives: To evaluate whether the use of sheaths to access the ureter has increased after the introduction of new digital ureterorenoscopes in patients undergoing flexible ureteroscopy. Methods: 140 patients with kidney stones were randomised to be scoped with either an old-generation fibre-optic flexible ureteroscope (DUR-8, Elite, ACMI; distal tip diameter = 6.75 Fr) or a new-generation digital LCD flexible ureteroscope (Invisio D-URD flexible ureteroscope; distal tip diameter = 8.7 Fr). We recorded the necessity to use a sheath to access the ureter, sheath-related and postoperative complications, and whether or not a JJ stent was left behind. Results: 157 (80 fibre-optic and 77 digital) ureterorenoscopies were performed. Ureteral access sheaths were used significantly more frequently with digital scopes (p = 0.00174). Two patients in the digital scope group had a small distal ureteric perforation from the introducer sheath compared with none in the fibre-optic scope group. Conclusions: A statistically significant increase in sheath use was observed in the new-generation digital flexible ureteroscopy group. Despite the improvement in image quality, better durability and improved stone clearance, there are some potential drawbacks of these scopes. The increased distal tip diameter can result in increased use of ureteric access sheaths and this may increase morbidity and expense.

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Section: Discussionmentioning

confidence: 99%

The New Digital Flexible Ureteroscopes: ‘Size Does Matter’ – Increased Ureteric Access Sheath Use!

et al. 2012

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“…8,19 Ureteral access sheaths were used routinely in 80% of the procedures to allow frequent passage of the ureteroscope to the collecting system, enable optimal visualization, maintain low intrarenal pressure, and to enable extraction of calculi fragments. [20][21][22] The use of access sheaths enhances the performance of the PolyScope in addition to allowing repeated, rapid, and nontraumatic placement into the upper urinary tract.…”

Section: Discussionmentioning

confidence: 99%

The PolyScope: A Modular Design, Semidisposable Flexible Ureterorenoscope System

Bader

Gratzke

Walther

et al. 2010

Journal of Endourology

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“…This is especially useful when retrieving multiple stone fragments after lithotripsy. 7 When it is prudent to inspect the entire ureter, a rigid ureteroscope is placed first.…”

Section: Discussionmentioning

confidence: 99%