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Evaluation of intrarenal pressure stability at different lithotripter suction settings in a porcine kidney model
Frank Strittmatter1, Udo Nagele2, Jörg Schachtner2
1Department of Urology, University Hospital of Munich, Marchioninistr 15, 8137, Munich, Germany. f.strittmatter@team-urologie.de.
Purpose:
Using the Swiss LithoClast® Trilogy, urinary stones can be fragmented and removed simultaneously by suction at different selectable suction settings. The aim was to evaluate pressure stability at different settings and test stone fragmentation and suction at the optimal settings.
Methods:
In an ex vivo porcine kidney model, we recorded intrarenal pressure levels with different suction levels. Storz® Nephroscopes MIP-M and MIP-L and Swiss LithoClast® Trilogy probes were used.
Results:
Pressure stabilized at 19 cm H2O with the MIP-M at 1 m gravity irrigation with no instrument introduced. After inserting the 1.5 mm probe, the pressure dropped to 5 cm H2O. With a suction setting of 10%, the pressure stabilized at 3 cm H2O and remained stable for the maximum time of 120 s. After increasing the suction to 20, 30, 40, and 50%, we recorded the pressure drop time to 0 after 22, 14, 11, and 8 s. Using the MIP-L, pressure stabilized at 44 cm H2O and decreased to 8 cm H2O after inserting the 3.4 mm probe. With 10% suction, a pressure stabilization was measured at 2 cm H2O and remained stable for 120 s. At suction levels of 20 and 30%, the pressure drop time to 0 was 6 and 5 s. With a 10% suction, removing stones was efficient, and the kidney's filling volume was maintained.
Conclusions:
When using the LithoClast® Trilogy, a suction setting of 10% seems to be optimal for the treatment of urinary calculi when applying suction continuously.
