V1720 URETEROSCOPIC OBSERVATION OF ULTRASONIC PROPULSION OF KIDNEY STONES

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You have accessJournal of UrologyTransplantation, Urolithiasis & Hydronephrosis1 Apr 2012V1720 URETEROSCOPIC OBSERVATION OF ULTRASONIC PROPULSION OF KIDNEY STONES Jonathan Harper, Mathew Sorensen, Ryan Hsi, Julianna Simon, Yak-Nam Wang, Marla Paun, Frank Starr, Wei Lu, Bryan Cunitz, and Michael Bailey Jonathan HarperJonathan Harper Seattle, WA More articles by this author , Mathew SorensenMathew Sorensen Seattle, WA More articles by this author , Ryan HsiRyan Hsi Seattle, WA More articles by this author , Julianna SimonJulianna Simon Seattle, WA More articles by this author , Yak-Nam WangYak-Nam Wang Seattle, WA More articles by this author , Marla PaunMarla Paun Seattle, WA More articles by this author , Frank StarrFrank Starr Seattle, WA More articles by this author , Wei LuWei Lu Seattle, WA More articles by this author , Bryan CunitzBryan Cunitz Seattle, WA More articles by this author , and Michael BaileyMichael Bailey Seattle, WA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1679AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Our research group is pursing FDA approval for a human feasibility study of a new device to use non-invasive transcutaneous ultrasound to expel small kidney stones from the kidney. The goal is to facilitate clearance of small stones or residual fragments post-treatment. Extensive testing of this device has been completed in the porcine model. This video shows the process of surgically implanting stones in a live porcine model followed by observations of ultrasonic propulsion of the stones in-situ. METHODS Four human stones or metalized glass beads (1-6 mm) were implanted by retrograde ureteroscopy in each kidney of 8 pigs (50-60kg). A bead was placed in the upper poles as a position reference easily seen on fluoroscopy. Our system is based on the Verasonics diagnostic ultrasound platform and utilizes a Philips HDI C5-3 imaging transducer. Stones were visualized ureteroscopically, with fluoroscopy, and our imaging/therapy ultrasound system during transcutaneous ultrasound propulsion repositioning. RESULTS Stones were successfully implanted in 14 of 16 kidneys. Tortuous ureteral anatomy and time prevented implantation in two kidneys. Over 75% of stones were moved to the ureteropelvic junction or ureter. Average ultrasound procedural time including imaging was less than 20 minutes. This video shows the surgical procedure to implant stones and stone repositioning using the transcutaneous ultrasound propulsion device visualized ureteroscopically, fluoroscopically, and with ultrasound. CONCLUSIONS Ultrasound expulsion of renal stones is possible in a live porcine model. The procedure relied on the skill and 3-D interpretation of an expert sonographer to apply the proper directional force necessary to reposition and expel calyceal stones. A decompressed collecting system, collecting system clot, narrow infundibulum or large stone burden increases the difficulty of ultrasonic propulsion © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e693 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jonathan Harper Seattle, WA More articles by this author Mathew Sorensen Seattle, WA More articles by this author Ryan Hsi Seattle, WA More articles by this author Julianna Simon Seattle, WA More articles by this author Yak-Nam Wang Seattle, WA More articles by this author Marla Paun Seattle, WA More articles by this author Frank Starr Seattle, WA More articles by this author Wei Lu Seattle, WA More articles by this author Bryan Cunitz Seattle, WA More articles by this author Michael Bailey Seattle, WA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...