PD37-03 PERCSAC: A NOVEL DEVICE TO PREVENT STONE FRAGMENT MIGRATION DURING PERCUTANEOUS LITHOTRIPSY

Abstract

You have accessJournal of UrologyStone Disease: New Technology II1 Apr 2014PD37-03 PERCSAC: A NOVEL DEVICE TO PREVENT STONE FRAGMENT MIGRATION DURING PERCUTANEOUS LITHOTRIPSY Jodi Antonelli, Justin Friedlander, Jeffrey Gahan, Heather Beardsley, Margaret Pearle, and Jeffrey Cadeddu Jodi AntonelliJodi Antonelli More articles by this author , Justin FriedlanderJustin Friedlander More articles by this author , Jeffrey GahanJeffrey Gahan More articles by this author , Heather BeardsleyHeather Beardsley More articles by this author , Margaret PearleMargaret Pearle More articles by this author , and Jeffrey CadedduJeffrey Cadeddu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.2021AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Up to 50% of patients with residual fragments after percutaneous nephrolithotomy (PCNL) experience a stone-related event. We developed a polyethylene sack (the PercSac) that fits over the shaft of a rigid nephroscope and is deployed in the collecting system to capture a stone, thereby containing fragments generated during PCNL and allowing for efficient and complete removal. We compared the efficiency of stone fragmentation and retrieval with and without the PercSac device in an in vitro percutaneous cystolitholapaxy model. METHODS Using a Limbs & Things® bladder model into which a 30F Amplatz working sheath was placed, 20 canine bladder stones matched for weight and volume were fragmented using a 24F rigid nephroscope and an ultrasonic lithotripter with and then without the PercSac. The total time for complete stone fragmentation and a gross assessment of the stone-free status of the bladder were recorded for each stone. RESULTS The mean stone weight and volume for the PercSac group was 2.63 +/- SD 0.95g and 1.68 +/- SD 0.63cm3, respectively. Similarly, the mean stone weight and volume for the group without the PercSac was 2.57 +/- SD 0.89g and 1.78 +/- SD 0.68cm3. The median time for complete stone fragmentation was significantly shorter in the PercSac group compared with the control group [182.0 sec (IQR= 108-221) vs 296.5 sec (IQR= 226-398), p= 0.004]. Likewise, the total time from insertion of the nephroscope into the bladder to completion of stone fragmentation was shorter for the PercSac group but this did not reach statistical significance [254.5 sec (IQR= 173-302) vs 296.5 sec (IQR= 226-398) respectively, p= 0.112]. The stone-free rate for the PercSac group was 100 vs 0% for the control group. CONCLUSIONS Ultrasonic lithotripsy using the PercSac device is more efficient and efficacious than traditional ultrasonic lithotripsy in a bladder model. This advantage may be even more pronounced during clinical PCNL where residual fragments migrate into difficult-to-access calyces. Further in vitro and in vivo testing in both kidney and bladder models is underway. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e946-e947 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Jodi Antonelli More articles by this author Justin Friedlander More articles by this author Jeffrey Gahan More articles by this author Heather Beardsley More articles by this author Margaret Pearle More articles by this author Jeffrey Cadeddu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...