The application potential of a modified wireless intelligent capsule cystoscope for dynamic detection of porcine bladder mucosa / 中华泌尿外科杂志

Objective:To develop an improved wireless intelligent capsule cystoscope (WCE)for dynamic detection of bladder mucosa in a pig model.Methods:The WCE was introduced into a healthy experimental pig that under general anesthesia via urethra by applying an improved device. Multi-angle images of the bladder mucosa were then obtained by controlling the position of capsule cystoscope with an external magnetic field system. The shutter speed of the WCE was 2.5 fps and was automatically converted to 1.5 fps 30 minutes after initiation. The Vue software was utilized to download the shoot pictures which were former received by a computer via wireless transmission. The pig was roused and sent to the pigpen, without limitations in moving. The improved WCE was connected with a 2 cm thread. 12 hours later, the dilated sheath was inserted again, and the capsule was removed by a foreign body forceps under observation of a ureteroscopy.Results:The WCE was successfully placed and removed from the pig's bladder with the application of the improved devices. Over 20 thousand images that with 60K pixels of bladder mucosa were captured by the WCE at various angles within 12 hours, which revealed the process of urine filling and excreting in a time-dependent way. No notable adverse effects (bleeding, urinary tract injury, etc) were noted during the process of cystoscope placement, image acquisition, transmission, and removal.Conclusion:This study developed a novel WCE that could dynamically, intelligently and accurately monitor all aspects of the pig bladder mucosa, and has preferable application prospect.

Minimal Hydrocelectomy with the aid of scrotoscope: a ten-year experience

Background Since hydrocelectomy remains the choice of surgical treatment of hydrocele and standard surgical procedures may cause postoperative discomfort and complications, a new minimal surgery procedure is needed. The scrotoscope was used for the diagnosis and treatment of intrascrotal lesions. The aim of the study is to illustrate a new minimal hydrocelectomy with the aid of scrotoscope, in an effort to decrease complications. Materials and Methods: Between 2002 and 2012, 65 patients underwent hydrocelectomy with the aid of a scrotoscope. Before carrying out hydrocelectomy, the scrotoscopy was first used to examine the intrascrotal contents to exclude any pathological lesions. After determining the condition of testis, epididymis and spermatic cord and excluding any other secondary causes of hydrocele, a 2.0cm scrotal incision was performed. The parietal tunica vaginalis was then grasped out of scrotum, and the mobilized tunica was excised. The scrotoscopy was then performed again to inspect the intrascrotal contents. Results Mean operative time was 35.4 minutes. No major complications occurred during the post-operative follow-up period. Of these 65 patients, 61 underwent scrotoscopy and minimal hydrocelectomy, two patients underwent open hydrocelectomy because thickening of hydrocele wall was identified; two patients with acute inflammation only underwent scrotoscopy. Pathological changes were observed among eight patients. All patients were satisfied with the outcomes. Conclusions Minimal hydrocelectomy shows commendable results and fewer complications. The combination of minimal hydrocelectomy and scrotoscopy seems to be an encouraging technique. This novel surgical procedure proves to be a viable option for the diagnosis and treatment of hydrocele. .

Laparoscopic Stone Surgery With the Aid of Flexible Nephroscopy

PURPOSE: To report the outcome of laparoscopic pyelo- and ureterolithotomies with the aid of flexible nephroscopy. MATERIALS AND METHODS: A retrospective analysis was performed in 71 patients with complex renal stones or large and impacted proximal ureteral stones. Patients underwent laparoscopic pyelo- or ureterolithotomies with or without the removal of small residual stones by use of flexible nephroscopy between July 2005 and July 2010. Operative success was defined as no residual stones in the intravenous pyelogram at 12 weeks postoperatively. Perioperative results and surgical outcomes were analyzed. RESULTS: The patients' mean age was 54.7+/-13.7 years, and 53 males (74.6%) and 18 females (25.4%) were included. The mean maximal stone size was 19.4+/-9.4 mm. A total of 47 cases were complex renal stones and 24 cases were impacted ureteral stones. Mean operative time was 139.0+/-63.7 minutes. Stones were completely removed in 61 cases (85.9%), and no further ancillary treatment was needed for clinically insignificant residual fragments in 7 cases (9.9%). For complex renal stones, the complete stone-free rate and clinically significant stone-free rate were 80.9% and 93.6%, respectively. Multivariate analysis showed that the use of flexible nephroscopy for complex renal stones can reduce the risk of residual stones. A major complication occurred in one case, in which open conversion was performed. CONCLUSIONS: Laparoscopic stone surgery is a safe and minimally invasive procedure with a high success rate, especially with the aid of flexible nephroscopy, and is not associated with procedure-specific complications.

Cystoscopic Extraction Technique and External Drainage Rescue of a Failed Attempt to Traverse a Severe Transplanted Ureteral Obstruction

PURPOSE: The aim of this research was to evaluate the efficacy of the cystoscopic extraction and external drainage techniques for unsuccessful antegrade stenting in transplanted severe ureteral obstruction. MATERIALS AND METHODS: A total of 26 patients with severe transplanted ureteral obstruction in whom the cystoscopic extraction technique and/or external drainage technique was performed were retrospectively evaluated. After the severe obstruction was successfully traversed, balloon dilatation followed by double-J stent insertion was performed. RESULTS: Of the 26 patients (male:female, 9:4; mean age, 38.1 years) who underwent failed ureteral stenting with the conventional procedure, 16 patients underwent successful stenting with the cystoscopic extraction technique, and 10 patients underwent successful stenting following external drainage. The mean serum creatinine of the 26 patients before stenting was 42.9 mg/dL (range, 32.7 to 54.1 mg/dL), which decreased to 10.3 mg/dL (range, 8.7 to 11.8 mg/dL) after stenting. The complications of the procedure were lower abdominal pain in 22 patients and gross hematuria in 9 patients. All complications were relieved with medical care within 3 to 5 days after the procedure. No major complications occurred. CONCLUSIONS: The cystoscopic extraction technique and external drainage technique are safe and useful for traversing a severe transplanted ureteral obstruction after a failed conventional procedure.

Imaging characteristic and clinical significance of vesical leukoplakia / 中华泌尿外科杂志

Objective To study the imaging characteristics of vesical leukoplakia under the cys-toscope imaging system. Methods The characteristics of vesical leukoplakia were observed under the cystoscope imaging system in 556 cases. After anti-infection treatment to these patients, the chan-ges of the characteristic under the cystoseope imaging system were re-observed and compared before and after treatment. SPSS 11.0 software package x2 teat for statistical analysis was used. Results Under the cystoscope imaging system, there were four different imaging manifestations in the 556 pa-tients. These were, from mild to severe, congestive type in 42 cases, spots type in 56 cases, thin macular type in 399 cases and thick macular type in 59 cases. One type could transform to another af-ter anti-infection treatment. When reexamination by the cystoscope, 131 cases got improved, 304 cases had no changes and 121 cases were aggravated. Statistical analysis showed the transformation among the 4 types had significant difference (x2 = 130.92, v=6, P<0.001). From congestive type to spots type, thin macular type and thick macular type, after anti-infection treatment, the ratio of improved cases decreased gradually, however the ratio of aggravated cases and cases without changes increased gradually. Conclusion Vesical leukoplakia could be classified into 4 types initially: congestive type,spots type, thin macular type, thick macular type. The different clinical treatments should be provid-ed.