A guidewire on your fingertip: A novel innovative technique

Ahmed Adam

doi:10.1016/j.afju.2018.10.001

Abstract

ObjectiveWe aimed to describe a novel method to attain direction and control of the guidewire at the fingertip. This will serve to allow for ease of guidewire placement during open and combined open and endoscopic surgery. Subjects and methodsOver a gloved hand, a ureteric catheter is placed over the index finger, with the distal tip over the distal end of the index finger. Thereafter, adhesive tape is applied over the ureteric catheter (over the proximal, and middle phalanges) to allow for ease of flexion of the index finger. A second glove is then covered over the first one, with care not to rotate or dislodge the fixated ureteric catheter. A small hole is cut at the distal end of the glove, at the tip of the ureteric catheter to allow the guidewire to exit. The guidewire is advanced easily and can now be directed using the ‘loaded’ fingertip. ResultsAn easily manipulated system of guidewire insertion, with fingertip mobility and dexterity is obtained utilizing everyday consumables in a simple to perform fashion. ConclusionA simple, novel method to allow flexibility and stress-free maneuvering to pass a guidewire, in open or combined open and endoscopic urological surgery is described.

Highlights

Various techniques have been described to gain ureteric access into both the orthotopic and abnormally placed Ureteric Orifices (UO)s [1–3], guidewire placement may be required during open and combined surgery as well
A ureteric catheter is placed over the index finger, with the tip at the distal end of the digit
Using the scissors a small cut is carried out at the distal end of the glove, at the tip of the ureteric catheter to allow for a guidewire to exit

Summary

Introduction

Various techniques have been described to gain ureteric access into both the orthotopic and abnormally placed Ureteric Orifices (UO)s [1–3], guidewire placement may be required during open and combined (open and endoscopic) surgery as well. The motivation and attitude of the surgeon is of paramount importance, the experienced tactile advantage using the finger is a valuable asset to the primary surgeon performing the operation. Despite the recent technological advancements, the role of the hand and fingers, its dexterity, tactile ability and surgical application is at the worst of times, difficult to replace [4]. We describe a novel method to attain direction and control of the guidewire at the fingertip

Subjects and methods

Ethics approval

Results

Conclusion