ABSTRACT
Flexible ureteroscopic incision and drainage is an innovative surgical option for renal parapelvic cysts these years.Finding the thinnest part of the renal parapelvic cyst is the key point of the surgery.This paper reports two patients with renal parapelvic cysts treated with flexible ureteroscopic incision and drainage combined with All-Seeing needle.The operations were successful and had good outcomes with the two-year follow-up.
ABSTRACT
Objective@#To evaluate the effectiveness and safety of percutaneous nephrolithotomy(PCNL) with the all-seeing needle system(Microperc)for the treatment of upper urinary calculi in children.@*Methods@#Retrospective analysis of 25 cases of upper urolithiasis treated with Microperc from November 2016 to January 2018 in Guizhou Provincial People′s Hospital was performed, including 18 boys and 7 girls.The age of patients was (6.4±3.9) years(10 months-14 years), and 4 cases were less than 3 years old.Among them, 3 cases had upper ureteral calculi and 22 cases had renal calculi.The mean stone size was 14.5 mm(8-20 mm). Stone fragmentation was performed by using a 200 μm holmium(YAG laser fiber).@*Results@#All patients were successfully treated in stage I. In 6 patients, access was achieved through the 4.8Fr all-seeing needle method.Conversion to mini-PCNL (10-12Fr) was required in 19 patients due to intraoperative bleeding and high stone burden.The duration of operation time was (60.8±15.1) min (40-100 min). The mean postoperative drop in hemoglobin was (7.5±5.4) g/L, and no patient required blood transfusion.The hospital stay was (4.9±1.2) days (3-6 days). There were residual fragments in 3 patients, and the overall stone-free rate at 4 weeks was 88%(22/25 cases). Four cases had a fever(Clavien grade Ⅰ) complications, while no grade Ⅱ and grade Ⅲ complications were observed.@*Conclusions@#Microperc can establish a surgical channel through visual images quickly and safely, and it greatly reduces the risk and difficulty in doing operation.This technology is not only suitable for learner of surgery, but also for patients with mild hydronephrosis and children with calculus.
ABSTRACT
Objective To evaluate the effectiveness and safety of percutaneous nephrolithotomy(PCNL) with the all-seeing needle system (Microperc) for the treatment of upper urinary calculi in children.Methods Retrospective analysis of 25 cases of upper urolithiasis treated with Microperc from November 2016 to January 2018 in Guizhou Provincial People's Hospital was performed,including 18 boys and 7 girls.The age of patients was (6.4 ± 3.9) years (10 months-14 years),and 4 cases were less than 3 years old.Among them,3 cases had upper ureteral calculi and 22 cases had renal calculi.The mean stone size was 14.5 mm(8-20 rmm).Stone fragmentation was performed by using a 200 μm holmium (YAG laser fiber).Results All patients were successfully treated in stage I.In 6 patients,access was achieved through the 4.8Fr all-seeing needle method.Conversion to mini-PCNL (10-12Fr) was required in 19 patients due to intraoperative bleeding and high stone burden.The duration of operation time was (60.8 ± 15.1) min (40-100 rain).The mean postoperative drop in hemoglobin was (7.5 ± 5.4) g/L,and no patient required blood transfusion.The hospital stay was (4.9 ± 1.2) days (3-6 days).There were residual fragments in 3 patients,and the overall stone-free rate at 4 weeks was 88％ (22/25 cases).Four cases had a fever(Clavien grade Ⅰ) complications,while no grade Ⅱ and grade Ⅲ complications were observed.Conclusions Microperc can establish a surgical channel through visual images quickly and safely,and it greatly reduces the risk and difficulty in doing operation.This technology is not only suitable for learner of surgery,but also for patients with mild hydronephrosis and children with calculus.
ABSTRACT
Objective To detect the feasibility and safety of applying all-seeing needle in transurethral seminal vesiculoscopy.Methods Retrospective analysis was made with clinical data of 32 patients of hemospermia treated with transurethral seminal vesiculoscopy using all-seeing needle from March 2016 to January 2018.The patients'age was (38.8 ± 8.7) years (27-60 years) and the course of disease was (7.1 ±3.3) months (2-15 months).Ultrasound before operation showed heterogeneous echo,or expansion of the seminal vesicle.MRI showed hemorrhage of the seminal vesicle,or abnormal signal of the seminal vesicle.Patients had levofloxacin or mosisasin anti-infection therapy more than one month and remained uncovered.The operation was performed under subarachnoid anesthesia,and the patients took the lithotomy position.The F4.8 all-seeing needle entered the posterior urethra,the verumontanum was found,and the saline was slowly pushed with a syringe to maintain a clear view.Then,the ejaculatory duct opening was searched on both sides of the verumontanum.If the ejaculatory duct opening cannot be found in the normal position,we entered the needle into the prostatic utricle to find the possible ectopic opening.If the ejaculatory duct opening was still not found,at the 5 and 7 o'clock positions in the prostatic utricle,the needle was probed and punctured into the side wall of the ejaculatory duct.Visible puncture with all-seeing needle can effectively avoid penetrating blood vessels and reduce damage to tissues during puncture.In this study,the ejaculatory duct opening got accessed on the verumontanum in 14 cases,through ectopic openings within the prostatic utricle in 2 cases,and through artificial establishment in 5 and 7 o'clock positions within prostatic utricle in 16 cases.After entering the ejaculatory duct and seminal vesicle,we explored the cavities of the seminal vesicles.For stones or polyps,after replacing the outer sheath to F8,F1.9 stone retrieval basket was applied to remove stones or polyps,followed by rinsing the seminal vesicles with normal saline,0.02％ nitrofurazone,and then 160,000 units of gentamicin into each seminal vesicle.For hemorrhage,after clearing up the blood,seminal vesicles were also washed with normal saline,nitrofurazone,and perfused with gentamicin.In the operation,prostatic utricle stone was found in 5 cases,and seminal vesicle stone was found in 7 cases.One case of seminal vesicle polyp was observed,and in 19 cases,seminal vesicle hemorrhage was seen.Results All the operations were accomplished successfully,the operation time was (55.0 ± 11.3) min (35-82 min).There was no rectal injury or urethral injury during operation.The postoperative catheter was removed at 2 days postoperatively and the patients discharged on the 4th day after surgery.The length of hospital stay was (6.3 ± 0.7) days (5-7 days).One patient had mild hematuria after removal of the urethral catheter and got improved spontaneously;one case developed epididymitis,which improved after anti-infective treatment.6 cases made stone analysis,with 5 cases of magnesium ammonium phosphate hexahydrate,and 1 case of calcium oxalate dihydrate,calcium oxalate monohydrate and carbonate apatite mixed stones.One case of polyp was diagnosed by pathologists to be an inflammatory polyp.Follow-up was performed at 4,6,8,and 12 weeks after surgery.Hemospermia was cured in 24 cases,relieved in the other 8 cases at 8-week follow-up,who received oral antibiotic treatment afterwards.At the 12-week follow-up,the rest 6 cases in 8 got hemospermia recovered,with 2 cases still uncovered.Conclusions All-seeing needle is user-friendly and safe in transurethral seminal vesiculoscopy,with reliable short-term efficacy.
ABSTRACT
Objective To discuss primary experience the clinical use of "All-seeing needle set" combined with Holmium laser to treat the single renal stone lesser than 2 cm in diameter through a super minimal tract (F12).Methods From January 2015 to December 2016,43 patients were enrolled into this retrospective study.There were 23 males and 20 females who were diagnosed as single renal stone less than 2 cm in diameter(age range from 23-65 years).There were 8 upper pole renal stones,13 lower pole renal stones and 22 renal pelvis stones.The mean stone size was (1.63 ± 0.32) cm in diameter (range from 1.2 cm to 2.0 cm)."All-seeing needle system" was applied during percutaneous puncture.After building a F12 minimal tract by fascia dilator,all patients received lithotripsy with Holmium laser.Indwelling catheters for 3 days and an F6 double-J tube was left for 2 weeks without a tube in the percutaneous tract after operation.Finally,KUB and/or urinary CT were used to check the results on day 1.Result All operations were completed successfully.The operation time was 23-65min [averaged (31.0 ±9.2) min].41 cases' renal stones were store free,and the 2 stone residues was clear with later extracorporeal shock wave lithotripsy.No severe complications occurred.Conclusion As an alternative to standard procedures for treatment of renal stones less than 2 cm in diameter,adopting "All-seeing needle set" with Holmium laser through a super minimal tract (F12) is safe,minimally invasive,fast and effective with a low complication rate.
ABSTRACT
Objective To observe the clinical application of all seeing needle system system in diagnosis and treatment of patients with hematospermia. Methods From May 2015 to September 2016, 22 patients with hemospermia were treated with seminal vesiculoscopy and seminal vesicle lithotripsy by using a all seeing needle system instead of traditional seminal vesicle. Results All the patients were successfully found the seminal vesicle gland and successfully entered the seminal vesicle gland, 16 cases had chronic inflammation of the seminal vesicle, dilute iodine rinse, 6 cases of seminal vesicle, holmium laser lithotripsy, stone basket to remove. The average operation time was (15.7 ± 6.2) min. The catheterization was performed the next day after operation. The average hospital stay was 2 d. After follow-up for 3 to 6 months, 20 patients had disappeared (90.9％). No complication was found Disease and long-term complications. Conclusion The all seeing needle system can replace the traditional seminal vesicle for the operation of seminal vesicle. The puncture system is short, directional and maneuverable. It has advantages of short operation time, simple operation, easy to master and no complications.