Steerable antegrade stenting: a new trick of the trade

Detalhes bibliográficos
Autor(a) principal: Nagele,Udo
Data de Publicação: 2007
Outros Autores: Anastasiadis,Aristotelis G., Amend,Bastian, Schilling,David, Kuczyk,Markus, Stenzl,Arnulf, Sievert,Karl-Dietrich
Tipo de documento: Artigo
Idioma: eng
Título da fonte: International Braz J Urol (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000300013
Resumo: INTRODUCTION: Whereas a retrograde attempt to insert an indwelling stent is performed in lithotomy position, usually renal access is gained in a prone position. To overcome the time loss of patient repositioning, a renal puncture can be performed in a modified lithotomy position with torqued truncus and slightly elevated flank. There is a two-fold advantage of this position: transurethral and transrenal access can be obtained using a combined approach. In the present study, this simple technique is used to position a floppy guide wire through a modified needle directly through the renal pelvis into the ureter. MATERIALS AND METHODS: The kidney is punctured in the modified lithotomy position under sonographic control using an initial three-part puncture needle. A floppy tip guide-wire is inserted into the collecting system via the needle after retrieving the stylet. The retracted needle is bent at the tip while the guide-wire is secured in the needle and the collecting system. The use of the floppy tip guide-wire helps to insert the curved needle back into the kidney pelvis, which becomes the precise guidance for the now steerable wire. The desired steerable stent is positioned under radiographic control in a retrograde fashion over the endoscopically harbored tip of the guide-wire. Two patient cohorts (newly described method and conventional method) were compared. RESULTS: The presented steering procedure saves 16.5 mean minutes compared to the conventional antegrade stenting and 79.5 Euros compared to the control group. CONCLUSION: The described combined antegrade-retrograde stent placement through a bent three-part puncture needle results in both clinical superiority (OR time, success rate) and financial benefits.
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spelling Steerable antegrade stenting: a new trick of the tradeureterstentnephrostomykidneyINTRODUCTION: Whereas a retrograde attempt to insert an indwelling stent is performed in lithotomy position, usually renal access is gained in a prone position. To overcome the time loss of patient repositioning, a renal puncture can be performed in a modified lithotomy position with torqued truncus and slightly elevated flank. There is a two-fold advantage of this position: transurethral and transrenal access can be obtained using a combined approach. In the present study, this simple technique is used to position a floppy guide wire through a modified needle directly through the renal pelvis into the ureter. MATERIALS AND METHODS: The kidney is punctured in the modified lithotomy position under sonographic control using an initial three-part puncture needle. A floppy tip guide-wire is inserted into the collecting system via the needle after retrieving the stylet. The retracted needle is bent at the tip while the guide-wire is secured in the needle and the collecting system. The use of the floppy tip guide-wire helps to insert the curved needle back into the kidney pelvis, which becomes the precise guidance for the now steerable wire. The desired steerable stent is positioned under radiographic control in a retrograde fashion over the endoscopically harbored tip of the guide-wire. Two patient cohorts (newly described method and conventional method) were compared. RESULTS: The presented steering procedure saves 16.5 mean minutes compared to the conventional antegrade stenting and 79.5 Euros compared to the control group. CONCLUSION: The described combined antegrade-retrograde stent placement through a bent three-part puncture needle results in both clinical superiority (OR time, success rate) and financial benefits.Sociedade Brasileira de Urologia2007-06-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000300013International braz j urol v.33 n.3 2007reponame:International Braz J Urol (Online)instname:Sociedade Brasileira de Urologia (SBU)instacron:SBU10.1590/S1677-55382007000300013info:eu-repo/semantics/openAccessNagele,UdoAnastasiadis,Aristotelis G.Amend,BastianSchilling,DavidKuczyk,MarkusStenzl,ArnulfSievert,Karl-Dietricheng2007-08-29T00:00:00Zoai:scielo:S1677-55382007000300013Revistahttp://www.brazjurol.com.br/ONGhttps://old.scielo.br/oai/scielo-oai.php||brazjurol@brazjurol.com.br1677-61191677-5538opendoar:2007-08-29T00:00International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)false
dc.title.none.fl_str_mv Steerable antegrade stenting: a new trick of the trade
title Steerable antegrade stenting: a new trick of the trade
spellingShingle Steerable antegrade stenting: a new trick of the trade
Nagele,Udo
ureter
stent
nephrostomy
kidney
title_short Steerable antegrade stenting: a new trick of the trade
title_full Steerable antegrade stenting: a new trick of the trade
title_fullStr Steerable antegrade stenting: a new trick of the trade
title_full_unstemmed Steerable antegrade stenting: a new trick of the trade
title_sort Steerable antegrade stenting: a new trick of the trade
author Nagele,Udo
author_facet Nagele,Udo
Anastasiadis,Aristotelis G.
Amend,Bastian
Schilling,David
Kuczyk,Markus
Stenzl,Arnulf
Sievert,Karl-Dietrich
author_role author
author2 Anastasiadis,Aristotelis G.
Amend,Bastian
Schilling,David
Kuczyk,Markus
Stenzl,Arnulf
Sievert,Karl-Dietrich
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Nagele,Udo
Anastasiadis,Aristotelis G.
Amend,Bastian
Schilling,David
Kuczyk,Markus
Stenzl,Arnulf
Sievert,Karl-Dietrich
dc.subject.por.fl_str_mv ureter
stent
nephrostomy
kidney
topic ureter
stent
nephrostomy
kidney
description INTRODUCTION: Whereas a retrograde attempt to insert an indwelling stent is performed in lithotomy position, usually renal access is gained in a prone position. To overcome the time loss of patient repositioning, a renal puncture can be performed in a modified lithotomy position with torqued truncus and slightly elevated flank. There is a two-fold advantage of this position: transurethral and transrenal access can be obtained using a combined approach. In the present study, this simple technique is used to position a floppy guide wire through a modified needle directly through the renal pelvis into the ureter. MATERIALS AND METHODS: The kidney is punctured in the modified lithotomy position under sonographic control using an initial three-part puncture needle. A floppy tip guide-wire is inserted into the collecting system via the needle after retrieving the stylet. The retracted needle is bent at the tip while the guide-wire is secured in the needle and the collecting system. The use of the floppy tip guide-wire helps to insert the curved needle back into the kidney pelvis, which becomes the precise guidance for the now steerable wire. The desired steerable stent is positioned under radiographic control in a retrograde fashion over the endoscopically harbored tip of the guide-wire. Two patient cohorts (newly described method and conventional method) were compared. RESULTS: The presented steering procedure saves 16.5 mean minutes compared to the conventional antegrade stenting and 79.5 Euros compared to the control group. CONCLUSION: The described combined antegrade-retrograde stent placement through a bent three-part puncture needle results in both clinical superiority (OR time, success rate) and financial benefits.
publishDate 2007
dc.date.none.fl_str_mv 2007-06-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000300013
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382007000300013
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S1677-55382007000300013
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Sociedade Brasileira de Urologia
publisher.none.fl_str_mv Sociedade Brasileira de Urologia
dc.source.none.fl_str_mv International braz j urol v.33 n.3 2007
reponame:International Braz J Urol (Online)
instname:Sociedade Brasileira de Urologia (SBU)
instacron:SBU
instname_str Sociedade Brasileira de Urologia (SBU)
instacron_str SBU
institution SBU
reponame_str International Braz J Urol (Online)
collection International Braz J Urol (Online)
repository.name.fl_str_mv International Braz J Urol (Online) - Sociedade Brasileira de Urologia (SBU)
repository.mail.fl_str_mv ||brazjurol@brazjurol.com.br
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