Percutaneous nephrostomy tract incision using modified Otis urethrotome.

Area of Science:

• Urology
• Surgical Innovation
• Minimally Invasive Procedures

Background:

• Nephrostomy tract dilation is crucial for percutaneous renal access.
• Traditional Amplatz dilation can be challenging in cases of renal fascial scarring.
• A need exists for more efficient and accessible dilation techniques.

Purpose of the Study:

• To describe a modification of the Otis urethrotome for nephrostomy tract dilation.
• To evaluate the efficacy and safety of this modified instrument.
• To compare its performance against the standard Amplatz technique.

Main Methods:

• Modification of an Otis urethrotome by creating a 3/16-inch hole for guidewire passage.
• Performance of 36 nephrostomy tract dilations using the modified instrument.
• Comparison of dilation time with 20 Amplatz tract dilations.

Main Results:

• The modified Otis urethrotome allowed passage over a 0.038-inch guidewire.
• 36 nephrostomy tract dilations were performed without significant complications.
• The new method was quicker (4.3 minutes vs. 6.5 minutes for Amplatz).

Conclusions:

• The modified Otis urethrotome is a safe and effective tool for nephrostomy tract dilation.
• This technique offers a significant time advantage over the Amplatz method.
• It is particularly beneficial for dilating tracts with renal fascial scarring.