Impact of irrigation systems on stone migration
Kari Hendlin1, Derek Weiland, Manoj Monga
1Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
Journal of Endourology
|March 22, 2008
Summary
Gravity-based ureteroscopic irrigation systems exert less force on stones than pump-driven devices. Among pump systems, the Boston Scientific Single-Action-Pump System (SAPS) applied the least force, minimizing potential stone migration during ureteroscopy.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Biomedical Engineering
Background:
- Ureteroscopy is a common procedure for treating kidney stones.
- Controlling stone migration during ureteroscopy is crucial for successful stone removal.
- Ureteroscopic irrigation systems can exert forces that may influence stone movement.
Purpose of the Study:
- To quantify and compare the forces exerted by various ureteroscopic irrigation systems on simulated stones.
- To determine which irrigation systems minimize forces that could cause stone migration.
Main Methods:
- A simulated stone was attached to a load cell within a ureteroscope in a simulated ureteral model.
- Different irrigation systems (gravity, pressurized, foot pump, and specialized devices) were tested.
- Forces exerted on the stone by each system were measured.
Main Results:
- Gravity-based systems applied the least force (< or =0.0006 Ns maximum impulse).
- The Boston Scientific Single-Action-Pump System (SAPS) required the fewest pumps and exerted the least force among hand-held devices.
- The Cook and ACMI Irri-Flo systems generated significantly greater average total maximum impulse.
Conclusions:
- Gravity-based irrigation systems are associated with lower forces on stones compared to pump-driven systems.
- The SAPS is a preferable hand-held option for minimizing stone migration forces during ureteroscopy.
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