Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)

Detalhes bibliográficos
Autor(a) principal: Lima, E
Data de Publicação: 2017
Outros Autores: Rodrigues, PL, Mota, P, Carvalho, N, Dias, E, Correia-Pinto, J, Autorino, R, Vilaça, JL
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.26/18250
Resumo: BACKGROUND: Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. OBJECTIVES: To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. DESIGN, SETTING, AND PARTICIPANTS: This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. SURGICAL PROCEDURE: Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. RESULTS AND LIMITATIONS: Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85kg/m2 (19-28.3), and median stone size was 2.13cm (1.5-2.5cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range 15-35). No complications occurred. CONCLUSIONS: We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. PATIENT SUMMARY: We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly facilitate one of the most challenging steps in percutaneous removal of kidney stones.
id RCAP_0ecc41cdce7955c0d704b647c0b5ec79
oai_identifier_str oai:comum.rcaap.pt:10400.26/18250
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)UreteroscopiaCálculos RenaisCálices RenaisBACKGROUND: Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. OBJECTIVES: To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. DESIGN, SETTING, AND PARTICIPANTS: This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. SURGICAL PROCEDURE: Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. RESULTS AND LIMITATIONS: Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85kg/m2 (19-28.3), and median stone size was 2.13cm (1.5-2.5cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range 15-35). No complications occurred. CONCLUSIONS: We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. PATIENT SUMMARY: We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly facilitate one of the most challenging steps in percutaneous removal of kidney stones.Repositório ComumLima, ERodrigues, PLMota, PCarvalho, NDias, ECorreia-Pinto, JAutorino, RVilaça, JL2017-04-27T20:12:45Z2017-04-012017-04-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.26/18250engEur Urol. 2017 Apr 1. pii: S0302-2838(17)30176-8.10.1016/j.eururo.2017.03.011info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2022-12-20T14:25:09Zoai:comum.rcaap.pt:10400.26/18250Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:22:44.357183Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
title Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
spellingShingle Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
Lima, E
Ureteroscopia
Cálculos Renais
Cálices Renais
title_short Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
title_full Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
title_fullStr Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
title_full_unstemmed Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
title_sort Ureteroscopy-assisted Percutaneous Kidney Access Made Easy: First Clinical Experience with a Novel Navigation System Using Electromagnetic Guidance (IDEAL Stage 1)
author Lima, E
author_facet Lima, E
Rodrigues, PL
Mota, P
Carvalho, N
Dias, E
Correia-Pinto, J
Autorino, R
Vilaça, JL
author_role author
author2 Rodrigues, PL
Mota, P
Carvalho, N
Dias, E
Correia-Pinto, J
Autorino, R
Vilaça, JL
author2_role author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório Comum
dc.contributor.author.fl_str_mv Lima, E
Rodrigues, PL
Mota, P
Carvalho, N
Dias, E
Correia-Pinto, J
Autorino, R
Vilaça, JL
dc.subject.por.fl_str_mv Ureteroscopia
Cálculos Renais
Cálices Renais
topic Ureteroscopia
Cálculos Renais
Cálices Renais
description BACKGROUND: Puncture of the renal collecting system represents a challenging step in percutaneous nephrolithotomy (PCNL). Limitations related to the use of standard fluoroscopic-based and ultrasound-based maneuvers have been recognized. OBJECTIVES: To describe the technique and early clinical outcomes of a novel navigation system for percutaneous kidney access. DESIGN, SETTING, AND PARTICIPANTS: This was a proof-of-concept study (IDEAL phase 1) conducted at a single academic center. Ten PCNL procedures were performed for patients with kidney stones. SURGICAL PROCEDURE: Flexible ureterorenoscopy was performed to determine the optimal renal calyx for access. An electromagnetic sensor was inserted through the working channel. Then the selected calyx was punctured with a needle with a sensor on the tip guided by real-time three-dimensional images observed on the monitor. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary endpoints were the accuracy and clinical applicability of the system in clinical use. Secondary endpoints were the time to successful puncture, the number of attempts for successful puncture, and complications. RESULTS AND LIMITATIONS: Ten patients were enrolled in the study. The median age was 47.1 yr (30-63), median body mass index was 22.85kg/m2 (19-28.3), and median stone size was 2.13cm (1.5-2.5cm). All stones were in the renal pelvis. The Guy's stone score was 1 in nine cases and 2 in one case. All 10 punctures of the collecting system were successfully completed at the first attempt without X-ray exposure. The median time to successful puncture starting from insertion of the needle was 20 s (range 15-35). No complications occurred. CONCLUSIONS: We describe the first clinical application of a novel navigation system using real-time electromagnetic sensors for percutaneous kidney access. This new technology overcomes the intrinsic limitations of traditional methods of kidney access, allowing safe, precise, fast, and effective puncture of the renal collecting system. PATIENT SUMMARY: We describe a new technology allowing safe and easy puncture of the kidney without radiation exposure. This could significantly facilitate one of the most challenging steps in percutaneous removal of kidney stones.
publishDate 2017
dc.date.none.fl_str_mv 2017-04-27T20:12:45Z
2017-04-01
2017-04-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.26/18250
url http://hdl.handle.net/10400.26/18250
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Eur Urol. 2017 Apr 1. pii: S0302-2838(17)30176-8.
10.1016/j.eururo.2017.03.011
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799130672804134912