Optical triradiate nephroscope: new concept in percutaneous renal surgery

Area of Science:

• Urology
• Surgical Instrumentation
• Nephrolithiasis Management

Background:

• Percutaneous renal surgery often results in high residual stone fragment rates after disintegration.
• Existing methods like electrohydraulic and ultrasonic lithotripsy can leave fragments, necessitating further procedures.

Purpose of the Study:

• To introduce a novel instrument, the optical triradiate nephroscope, designed for intact calculus extraction.
• To address the limitations of current stone disintegration techniques in percutaneous renal surgery.

Main Methods:

• Development of an optical triradiate nephroscope (Wickham/Miller, Karl Storz GmbH) with specialized grasping jaws.
• Utilizing the instrument for the extraction of renal calculi ranging from 0.8 mm to 1.5 cm.
• Application in both one-stage and two-stage percutaneous renal surgery procedures.

Main Results:

• The instrument effectively grasps calculi with a secure, vice-like grip, preventing dislodgement during extraction.
• Successful intact removal of stones, significantly reducing residual fragment rates.
• Demonstrated utility and value in various percutaneous renal surgery scenarios.

Conclusions:

• The optical triradiate nephroscope is a valuable addition to the basic kit for percutaneous renal surgery.
• This instrument offers an effective solution for reducing residual fragments and improving stone clearance.
• The reported techniques and principles of triradiate grasping enhance surgical efficacy.