PD23-04 EFFICACY OF REAL-TIME VIRTUAL SONOGRAPHY-GUIDED RENAL ACCESS FOR ENDOSCOPIC COMBINED INTRARENAL SURGERY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy IV1 Apr 2016PD23-04 EFFICACY OF REAL-TIME VIRTUAL SONOGRAPHY-GUIDED RENAL ACCESS FOR ENDOSCOPIC COMBINED INTRARENAL SURGERY Shuzo Hamamoto, Rei Unno, Kazumi Taguchi, Ryosuke Ando, Atsushi Okada, Keiichi Tozawa, Kenjiro Kohri, and Takahiro Yasui Shuzo HamamotoShuzo Hamamoto More articles by this author , Rei UnnoRei Unno More articles by this author , Kazumi TaguchiKazumi Taguchi More articles by this author , Ryosuke AndoRyosuke Ando More articles by this author , Atsushi OkadaAtsushi Okada More articles by this author , Keiichi TozawaKeiichi Tozawa More articles by this author , Kenjiro KohriKenjiro Kohri More articles by this author , and Takahiro YasuiTakahiro Yasui More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1743AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Real-time virtual sonography (RVS) is a diagnostic imaging support system that can be synchronized with real-time ultrasonography in conjunction with computed tomography (CT) using a magnetic navigation system. The application of RVS for percutaneous nephrolithotomy has not yet been reported. This study aimed to examine the effect of RVS-guided renal access during endoscopic combined intrarenal surgery (ECIRS) for large renal calculi. METHODS We retrospectively evaluated 12 patients with large renal calculi (35.1 ± 3.3 mm) who underwent ECIRS in our center between April 2014 and January 2015. The Digital Imaging and Communication in Medicine volume data from preoperative CT performed in the prone position were loaded in the RVS unit. The operation was performed as follows: 1) All of the patients were oriented in the prone split-leg position to allow for retrograde and antegrade access; 2) One urologist performed retrograde intrarenal surgery by using a Holmium-YAG laser with a ureteroscope through a ureteral access sheath, while the other performed renal puncture using the RVS system (Figure); and 3) After inserting the percutaneous tract, each urologist worked simultaneously to fragment the renal calculi. RESULTS All of the procedures were successfully performed using a single tract. The mean number of renal punctures until gaining renal access through the calyx, which provides the best access to the calculus, was 1.6. The mean surgical duration was 107.0 ± 10.5 minutes, and the mean length of hospital stay was 5.3 ±0.5 days. The mean decrease in hemoglobin level was 0.76 ± 0.15 g/dL. Complete stone clearance after a single ECIRS treatment session was achieved in 7 patients (87.5%). None of the patients required a blood transfusion and had a Clavien grade ≥ 2. CONCLUSIONS RVS-guided renal access improved the precision of the calyceal puncture, which decreased the incidence of bleeding complications and improved the stone clearance rates during ECIRS. This is the first report to evaluate the efficacy of the RVS system for renal access. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e507 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Shuzo Hamamoto More articles by this author Rei Unno More articles by this author Kazumi Taguchi More articles by this author Ryosuke Ando More articles by this author Atsushi Okada More articles by this author Keiichi Tozawa More articles by this author Kenjiro Kohri More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...