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Related Concept Videos

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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A kidney transplant is a surgical approach that involves replacing a non-functioning kidney with a healthy one from a donor. This procedure is often a treatment option for end-stage renal disease (ESRD) patients. The method requires careful recipient selection, including evaluating various medical and psychosocial factors. These criteria vary between transplant centers but generally include assessments of the patient's overall health, adherence to medical recommendations, and lifestyle...
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Continuous Renal Replacement Therapy, also known as CRRT, is a procedural treatment for acute kidney injury (AKI) that gradually removes uremic toxins and fluids while maintaining acid-base balance and stabilizing electrolytes. It is particularly useful for hemodynamically unstable patients. Unlike intermittent hemodialysis, which is faster, CRRT provides a gentler approach over 24 hours, closely mimicking the function of natural kidneys. However, CRRT is not ideal for patients with...
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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Direct Drug Delivery to Kidney via the Renal Artery
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Kidney access device.

Jasneet Singh Bhullar1, Robert Scott2, Mitesh Patel1

  • 1Department of Surgery.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|December 10, 2014
PubMed
Summary
This summary is machine-generated.

A novel kidney access device (KAD) simplifies percutaneous nephrolithotomy by enabling precise renal puncture. This tool significantly reduces operative time and fluoroscopy exposure, making complex stone surgery more accessible.

Keywords:
Kidney punctureKidney puncture devicePCNLPercutaneous nephrolithotomyRenal puncture

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Percutaneous nephrolithotomy (PCNL) presents a steep learning curve, primarily due to the complexity of achieving accurate renal access.
  • Misaligned punctures during PCNL can result in severe bleeding, surgical failure, and patient complications.
  • Prolonged operative and fluoroscopic times increase risks for both patients and surgeons during PCNL.

Purpose of the Study:

  • To develop and evaluate a kidney access device (KAD) designed to simplify and improve the accuracy of renal puncture in PCNL.
  • To overcome the challenges associated with the learning curve of renal access techniques.
  • To assess the KAD's efficacy in facilitating precise needle placement for targeting specific calyces.

Main Methods:

  • A novel kidney access device (KAD) was designed to aid in aligning the 3-dimensional targeted calyx under fluoroscopy.
  • A 3-step puncture technique was formulated using the KAD in a porcine model.
  • The KAD was utilized to puncture 3 targeted calyces in bilateral kidneys of 4 pigs, followed by guidewire insertion.

Main Results:

  • The average time for each renal puncture using the KAD was 4 ± 2 minutes.
  • Post-procedure necropsy revealed no instances of retroperitoneal hematoma, visceral organ injury, or active bleeding.
  • All 24 puncture sites demonstrated precise intrarenal guidewire placement within the targeted calyces.

Conclusions:

  • The KAD, combined with the 3-step technique, facilitates safe and accurate renal puncture, even for novice surgeons.
  • This approach significantly reduces operative and fluoroscopy times in PCNL.
  • The KAD shows potential for broader applications in accessing other organs and in various minimally invasive surgical procedures.