The ureteroscope as a safety wire for ureteronephroscopy
Sutchin R Patel1, Ian D McLaren, Stephen Y Nakada
1Department of Urology, University of Wisconsin School of Medicine and Public Health, 600 Highland Drive, Madison, WI 53792-7375, USA.
Journal of Endourology
|November 19, 2011
Summary
Flexible ureteroscopy for kidney stones is safe without a safety wire, using the ureteroscope as the primary safety device. This approach simplifies the procedure while maintaining renal access and control effectively.
Area of Science:
- Urology
- Endourology
- Minimally Invasive Surgery
Background:
- Technological advancements in flexible ureteroscopes have improved diagnostic and therapeutic capabilities.
- Ureteroscopy is a common procedure for managing renal calculi (kidney stones).
- Traditionally, safety wires are used to maintain access during ureteroscopy.
Purpose of the Study:
- To evaluate the safety and efficacy of performing ureteroscopy and lithotripsy for renal calculi without a safety wire.
- To assess the feasibility of using the ureteroscope itself as the primary safety device for maintaining renal access.
Main Methods:
- Retrospective review of medical records from December 2006 to December 2009.
- Inclusion of adult patients who underwent wireless flexible ureteroscopy for renal calculi management.
- Analysis of data from 268 patients with at least 1 month of follow-up.
Main Results:
- The study included 268 patients with a mean age of 33 years and a mean BMI of 33.1 kg/m².
- The mean stone diameter was 12.0±5.9 mm; 84% of patients received a ureteral stent post-procedure.
- The overall complication rate was 2.6% (0.7% major, 1.9% minor), with no cases of ureteral perforation or avulsion.
Conclusions:
- Flexible ureteroscopy without a safety wire is a safe and effective method for managing renal calculi.
- Utilizing the ureteroscope as the safety mechanism ensures renal access and control.
- Routine safety wires may not be necessary when the ureteroscope is confirmed to be within the kidney.
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