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Significance of Extraction Forces in Kidney Stone Basketing
Zahra Najafi1, Thomas Tieu2, Ajay M Mahajan1
11 Department of Biomedical Engineering, The University of Akron , Akron, Ohio.
Journal of Endourology
|June 10, 2015
Summary
Ureteroscopic stone extraction can injure the ureter. Measuring forces revealed significant differences between clinicians, suggesting a need for force feedback training to improve patient outcomes.
Area of Science:
- Urology
- Medical Device Engineering
Background:
- Ureteroscopic stone extraction is a common procedure for urolithiasis management.
- Improper use of extraction devices can lead to serious ureteral complications like avulsion and perforation.
Purpose of the Study:
- To measure the forces applied during ureteroscopic stone extraction.
- To identify force ranges that may cause ureteral injury.
- To inform the development of devices that enhance surgical safety.
Main Methods:
- Two test setups were used to measure avulsion and perforation forces.
- Eleven clinicians applied forces in safe, cautious, and dangerous ranges.
- Force measurements were recorded and analyzed, comparing benchtop and ex-vivo porcine ureter tests.
Main Results:
- Maximal average perforation forces were approximately 7.1 N in both benchtop and ex-vivo tests.
- Maximal average avulsion forces were approximately 10.1 N in benchtop tests.
- Extraction forces differed significantly between attending physicians and residents, indicating a need for training.
Conclusions:
- The study provides critical force data for ureteroscopic stone extraction.
- Findings support the development of 'smart devices' with visual force feedback.
- Implementing such technology can potentially improve patient outcomes by preventing ureteral injury.
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