An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System.

Background: Suction-assisted laryngoscopy and airway decontamination (SALAD) is a new modality and training manikins are quite costly. Few modifications have been described with their pluses and minuses. We describe a low-cost simulator that replicates fluid contamination of the airway at various flow rates and allows the practice of SALAD in vitro. Materials and methods: We modified a standard Laerdal airway management trainer with locally available equipment to simulate varying rates of continuous vomiting or hemorrhage into the airway during intubation. The effectiveness of our SALAD simulator was tested during an advanced airway workshop of the Airway Management Foundation (AMF). The workshop had a brief common presentation on the learning objective of the SALAD technique followed by a demonstration to small groups of 5-6 participants at one time with necessary instructions. This was followed by a hands-on practical learning session on the simulator. Results: One hundred and five learners used the simulator including 15 faculties and 90 participants (48 on ICU and 42 on ENT workstations). At the end of the session, the workshop faculty and participants were asked to rate their level of confidence in managing similar situations in real practice on a four-point Likert scale. All 15 faculty members and 70 out of 90 participants felt very confident in managing similar situations in real practice. Fifteen participants felt fairly confident and 5 felt slightly confident. Conclusion: In resource-limited settings, our low-cost SALAD simulator is a good educational tool for training airway managers in the skills of managing continuously and rapidly soiling airways. How to cite this article: Kumar R, Kumar R. An Indigenous Suction-assisted Laryngoscopy and Airway Decontamination Simulation System. Indian J Crit Care Med 2024;28(7):702-705.

Patent conversion of a novel closed chest drainage device.

Closed chest drainage is typically necessary following Lobar and Sublobar resections to evacuate gases and fluids from the thoracic cavity, eliminate residual pleural space for lung expansion, and maintain negative pressure. Currently, three conventional closed chest drainage systems are commonly employed: single-chamber, double-chamber, and triple-chamber systems; each system has its own advantages and disadvantages. Despite the emergence of digital drainage systems in recent years, their high cost hinders their widespread adoption. Based on this premise, our research team has achieved a patent for a micro air pump-integrated chest closed drainage bottle, which has been further developed into a novel device integrating a three-chamber system with negative pressure control and power supply capabilities. This device enables patients undergoing perioperative lung procedures to ambulate freely while simultaneously receiving chest suction therapy-a concept that theoretically promotes rapid postoperative recovery. Moreover, this device offers economic benefits and holds potential for clinical implementation (particularly in economically underdeveloped regions). In this article, we modified the thoracic closed drainage device based on our patent and presented this novel thoracic closed drainage device after 3D printing and assembly.

Highly Adaptive Kirigami-Metastructure Adhesive with Vertically Self-Aligning Octopus-like 3D Suction Cups for Efficient Wet Adhesion to Complexly Curved Surfaces.

An essential requirement for biomedical devices is the capability of conformal adaptability on diverse irregular 3D (three-dimensional) nonflat surfaces in the human body that may be covered with liquids such as mucus or sweat. However, the development of reversible adhesive interface materials for biodevices that function on complex biological surfaces is challenging due to the wet, slippery, smooth, and curved surface properties. Herein, we present an ultra-adaptive bioadhesive for irregular 3D oral cavities covered with saliva by integrating a kirigami-metastructure and vertically self-aligning suction cups. The flared suction cup, inspired by octopus tentacles, allows adhesion to moist surfaces. Additionally, the kirigami-based auxetic metastructure with a negative Poisson's ratio relieves the stress caused by tensile strain, thereby mitigating the stress caused by curved surfaces and enabling conformal contact with the surface. As a result, the adhesive strength of the proposed auxetic adhesive is twice that of adhesives with a flat backbone on highly curved porcine palates. For potential application, the proposed auxetic adhesive is mounted on a denture and performs successfully in human subject feasibility evaluations. An integrated design of these two structures may provide functionality and potential for biomedical applications.

Novel perfusion system using continuous liquid-suction catheter attachment in colorectal endoscopic submucosal dissection with water pressure method (with video).

Water pressure method (WPM) is useful for colorectal endoscopic submucosal dissection (ESD), characterized not only by underwater conditions but also by active water pressure via the waterjet function. However, the extension of the colorectum by injecting excess water and contaminating the operative field by stool and bleeding have been issues. This study aimed to evaluate the feasibility of a novel perfusion system using a continuous liquid-suction catheter attachment (CLCA) in colorectal ESD with WPM. We retrospectively reviewed cases in which the perfusion system was used in colorectal ESD with WPM between August 2022 and September 2023. We evaluated clinical characteristics, treatment outcomes, volume of injection by the waterjet function, volume of suction by the endoscope and CLCA, and concentration of floating matter in the operative field over time. Thirty-one cases were enrolled. The median lesion size was 30 (range, 15-100) mm. In all cases, en bloc resection was achieved without perforation. The median injection volume was 2312 (range, 1234-13,866) g. The median suction volumes by the endoscope and CLCA were 918 (range, 141-3162) and 1147 (range, 254-11,222) g, respectively. The median concentration of floating matter in the operative field (measured in 15 cases) was 15.3 (range, 7.3-112) mg/mL when the endoscope arrived at the lesion and 8.0 (range, 3.2-16) mg/mL after endoscopically washing at the beginning of the ESD. It ranged from 7.6 to 13.4 mg/dL every 20 min during ESD. This perfusion system could prevent the extension of the lumen and maintain a good field of view in colorectal ESD with WPM.

Reduction in lower urinary tract mucosal microtrauma as an effect of reducing eyelet sizes of intermittent urinary catheters.

Intermittent catheterization (IC) utilizing conventional eyelets catheters (CECs) for bladder drainage has long been the standard of care. However, when the tissue of the lower urinary tract comes in close proximity to the eyelets, mucosal suction often occurs, resulting in microtrauma. This study investigates the impact of replacing conventional eyelets with a drainage zone featuring multiple micro-holes, distributing pressure over a larger area. Lower pressures limit the suction of surrounding tissue into these micro-holes, significantly reducing tissue microtrauma. Using an ex vivo model replicating the intra-abdominal pressure conditions of the bladder, the intra-catheter pressure was measured during drainage. When mucosal suction occurred, intra-catheter images were recorded. Subsequently affected tissue samples were investigated histologically. The negative pressure peaks caused by mucosal suction were found to be very high for the CECs, leading to exfoliation of the bladder urothelium and breakage of the urothelial barrier. However, a micro-hole zone catheter (MHZC) with a multi-eyelet drainage zone showed significantly lower pressure peaks, with over 4 times lower peak intensity, thus inducing far less extensive microtraumas. Limiting or even eliminating mucosal suction and resulting tissue microtrauma may contribute to safer catheterizations in vivo and increased patient comfort and compliance.

Abdominal wound closure in the presence of sepsis: our experience with the use of subcutaneous drain.

Objectives: Patients requiring surgery for secondary peritonitis demonstrate a significantly increased risk for incisional surgical site infection. This study aimed to evaluate the efficacy of subcutaneous wound drain post-laparotomy for contaminated surgical wounds. Design: This was a prospective comparative hospital-based study. Setting: Patients who had surgery for secondary peritonitis in Irrua Specialist Teaching Hospital were studied. Participants: Fifty patients aged 16 years and above who presented with secondary peritonitis. Intervention: Patients who met the inclusion criteria were randomized into two equal groups. Group A had a suction drain placed in the subcutaneous space after laparotomy while Group B did not. Main outcome measures: Development of incisional surgical site infection, wound dehiscence, and duration of post-operative hospital stay. Results: The incidence of incisional surgical site infection was significantly less in Group A (20%) than in Group B (68%). There was no case of wound dehiscence in Group A as against 3 (12%) in Group B. The difference was not statistically significant. The mean duration of hospital stay was significantly less with subcutaneous suction drain (8.96+2.81 Vs 14.04+8.05; p = 0.005). Conclusion: Subcutaneous suction drainage is beneficial in abdominal wall closure in cases of peritonitis as it significantly reduces the incidence of incisional surgical site infection and the duration of postoperative hospital stay. The reduction in surgical wound dehiscence observed in this study was, however, not statistically significant. Funding: None declared.

Safety of Breast Liposuction and Oncologic Considerations.

Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The necessity of suction drainage when intra-articular injection of tranexamic acid is used during primary total knee arthroplasty: a retrospective study.

BACKGROUND: Suction drainages are commonly used after total knee arthroplasty (TKA) procedures; however, their use is somewhat controversial. Recently, some reports have claimed that the administration of tranexamic acid (TXA) may prevent postoperative bleeding following TKAs. Although numerous studies have reported regarding different dosages, timings of administration, or drain clamping times for intravenous and intra-articular TXA injections (IA-TXAs), few have examined whether suction drainage is necessary when TXA is administered. In this study, we compared using suction drainage without TXA administration and IA-TXA without suction drainage and aimed to examine the need for suction drainage during IA-TXA. METHODS: This retrospective study was conducted on 217 patients who had received TKA for osteoarthritis; 104 were placed on suction drainage after TKA without TXA (Group A), whereas the remaining 113 received IA-TXA immediately after surgery without suction drainage (Group B). Our clinical evaluation included assessments of the need for transfusion, presence of postoperative complications, incidence of deep vein thrombosis (DVT), and changes in hemoglobin (Hb), hematocrit (Hct), and D-dimer levels. RESULTS: No significant differences were observed in terms of postoperative complications and preoperative Hb, Hct, or D-dimer levels between the two groups. Although the prevalence of DVT was significantly higher in Group B (p < 0.05), all cases were asymptomatic. Hb and Hct levels were significantly lower in Group A than in Group B at 1, 3, 7, and 14 days postoperatively (p < 0.05), although none of the cases required blood transfusions. D-dimer levels were significantly higher in Group A than in Group B at 1 and 3 days postoperatively (p < 0.05). CONCLUSION: Suction drainage might not be necessary when IA-TXA is administered after TKA procedures.

Classification and Evaluation of Octopus-Inspired Suction Cups for Soft Continuum Robots.

The emergence of the field of soft robotics has led to an interest in suction cups as auxiliary structures on soft continuum arms to support the execution of manipulation tasks. This application poses demanding requirements on suction cups with respect to sensorization, adhesion under non-ideal contact conditions, and integration into fully soft systems. The octopus can serve as an important source of inspiration for addressing these challenges. This review aims to accelerate research in octopus-inspired suction cups by providing a detailed analysis of the octopus sucker, determining meaningful performance metrics for suction cups on the basis of this analysis, and evaluating the state-of-the-art in suction cups according to these performance metrics. In total, 47 records describing suction cups are found, classified according to the deployed actuation method, and evaluated on performance metrics reflecting the level of sensorization, adhesion, and integration. Despite significant advances in recent years, the octopus sucker outperforms all suction cups on all performance metrics. The realization of high resolution tactile sensing in suction cups and the integration of such sensorized suction cups in soft continuum structures are identified as two major hurdles toward the realization of octopus-inspired manipulation strategies in soft continuum robot arms.

Role of low-pressure negative pleural suction in patients with thoracic trauma - a randomized controlled trial.

BACKGROUND: Thoracic trauma frequently includes a pneumothorax, hemothorax, or hemopneumothorax, which may necessitate an Intercostal drainage (ICD) for air and fluid evacuation to improve breathing and circulatory function. It is a simple and life-saving procedure; nevertheless, it carries morbidity, even after its removal. Efforts have been made continuously to shorten the duration of ICD, but mostly in non-trauma patients. In this study, we evaluated the impact of negative pleural suction over the duration of ICD. METHODS: This study was a prospective randomized controlled interventional trial conducted at Level 1 Trauma Centre. Thoracic trauma patients with ICD, who met the inclusion criteria (sample size 70) were randomized into two groups, the first group with negative pleural suction up to -20 cm H2O, and the second group as conventional, i.e. ICD connected to underwater seal container only. The primary objective was to compare the duration of ICDs and the secondary objectives were the length of hospital stay and various complications of thoracic trauma. RESULTS: Duration of ICD was measured in median days with minimum & maximum days. For the negative suction group, it was 4 days (2-16 days); for the conventional group, it was also 4 days (2-17 days). There was also no significant difference among both groups in length of hospital stay. CONCLUSION: The beneficial effect of negative pleural suction to ICD could not be demonstrated over the duration of ICD and hospital stay. In both groups, there was no significant difference in complication rates like recurrent pneumothorax, retained hemothorax, persistent air leak, and empyema. LEVEL OF EVIDENCE: Therapeutic Study, Level II TRIAL REGISTRATION: This trial was registered with the Clinical Trial Registry of India (CTRI) with registration no. REF/2020/11/038403.

Performing Suction Blister Skin Biopsies.

Traditional skin sampling methods include punch or shave biopsies to produce a solid tissue sample for analysis. These biopsy procedures are painful, require anesthesia, and leave permanent scars. This unit describes a suction blister skin biopsy method that can be used in place of traditional biopsy methodologies as a minimally invasive, non-scarring skin sampling technique. The induction of suction blisters uses an instrument with a chamber that applies negative pressure and gentle heat to the skin. Blister formation occurs within 1 hr, producing up to five blisters, each 10 mm in diameter per biopsy site. Blister fluid can be extracted and centrifuged to retrieve cells from the epidermis and upper dermis for flow cytometry, single-cell RNA sequencing, cell culture, and more without the need for digestion protocols. In addition, the blister fluid can be used to measure soluble proteins and metabolites. This unit describes the preparation of supplies and subjects, the suction blister biopsy procedure and blister formation, fluid extraction, and post-blistering care. © 2024 Wiley Periodicals LLC. Basic Protocol 1: Preparation of supplies and subject Basic Protocol 2: Suction blister biopsy procedure and formation Basic Protocol 3: Blister fluid extraction Basic Protocol 4: Post-blister care and clean up.

Development and verification of a novel bone collector with automatic size separating function for orthopedics surgery.

BACKGROUND: Autologous bone dust can be filled in bone defects to promote effective bone healing but typically it is lost when using suction during surgery. The aim of this study was to develop a novel bone collector that can be used to collect bone chips/dust of varying sizes without changing current surgical procedures. RESEARCH DESIGN AND METHODS: This collector was designed to connect to a surgical continuous suction system and comprised a plate filter with a 3 mm hole and featured a taper filter with a mesh size of 0.27 mm for the separation and collection of both coarse and fine bone chips/dust. The bone collector was manufactured using nylon 3D printing and plastic injection with biocompatible materials. RESULTS: The bone collector functional test revealed high bone chip collection efficiency (93%) with automatic size separation function. Low (3.42%) filtration errors showed that most of the water can be drained smoothly from the bone collector. In clinical usability testing, bone collectors can provide functions demonstrated in in vivo spinal fusion and femoral fracture surgeries with different bone grafting size requirements. CONCLUSIONS: The novel bone collector has been validated as a viable and effective surgical device, offering surgeons an additional option to enhance patient outcomes.

Design and experiment of impeller seed guide device for rice internal suction hole direct seeding device.

Multi-grain hole-forming sowing and uniform hole spacing are important agronomic requirements for precise hole-direct seeding of rice.This paper designs a kind of impeller type seed guiding device. The main structural parameters of the impeller seed guide device were analyzed by constructing the kinematics model of the rice seed in the impeller seed guide process. The experiment analysis were carried out with the long-grain rice variety Chuangliangyou 4418 as the seeding object. The optimal structural parameter combination of seeding-guiding device was determined as inner impeller radius 56 mm, blade offset angle 11° and seeding angle 36°. On this basis, the seeding performance test of different seed guiding devices of internal suction seed-metering device was carried out by using rice seeds with different external dimensions. The test results show that the impeller has better cavitation and hole spacing uniformity than the seed guide tube. The average hole diameter is not higher than 21.7 mm, the qualified rate of hole diameter is not lower than 96.1%, and the coefficient of variation of hole spacing is not higher than 10.1%. Compared with the seed guide tube, which is increased by 32%, 16% and 34% respectively, and the average hole distance is about 200 mm in theory.

Unlocking Versatility: Magnetic-Actuated Deployable Suction Gripper for Complex Surface Handling.

Suction grippers offer a distinct advantage in their ability to handle a wide range of items. However, attaching these grippers to irregular and rough surfaces presents an ongoing challenge. To address this obstacle, this study explores the integration of magnetic intelligence into a soft suction gripper design, enabling fast external magnetic actuation of the attachment process. Additionally, miniaturization options are enhanced by implementing a compliant deploying mechanism. The resulting design is the first-of-its-kind magnetically-actuated deployable suction gripper featuring a thin magnetic membrane (Ø 50 mm) composed of carbonyl iron particles embedded in a silicone matrix. This membrane is supported by a frame made of superelastic nitinol wires that facilitate deployment. During experiments, the proof-of-principle prototype demonstrates successful attachment on a diverse range of curved surfaces in both dry and wet environments. The gripper achieves attachment on curved surfaces with radii of 50-75 mm, exerting a maximum attachment force of 2.89 ± 0.54 N. The current gripper design achieves a folding percentage of 75%, enabling it to fit into a Ø 12.5 mm tube and access hard-to-reach areas while maintaining sufficient surface area for attachment forces. The proposed prototype serves as a foundational steppingstone for further research in the development of reliable and effective magnetically-actuated suction grippers across various configurations. By addressing the limitations of attachment to irregular surfaces and exploring possibilities for miniaturization and precise control, this study opens new avenues for the practical application of suction grippers in diverse industries and scenarios.

Intravital Microscopy for Imaging and Live Cell Tracking of Alveolar Macrophages in Real Time.

Classic in vitro coculture assays of pathogens with host cells have contributed significantly to our understanding of the intracellular lifestyle of several pathogens. Coculture assays with pathogens and eukaryotic cells can be analyzed through various techniques including plating for colony-forming units (CFU), confocal microscopy, and flow cytometry. However, findings from in vitro assays require validation in an in vivo model. Several physiological conditions can influence host-pathogen interactions, which cannot easily be mimicked in vitro. Intravital microscopy (IVM) is emerging as a powerful tool for studying host-pathogen interactions by enabling in vivo imaging of living organisms. As a result, IVM has significantly enhanced the understanding of infection mediated by diverse pathogens. The versatility of IVM has also allowed for the imaging of various organs as sites of local infection. This chapter specifically focuses on IVM conducted on the lung for elucidating pulmonary immune response, primarily involving alveolar macrophages, to pathogens. Additionally, in this chapter we outline the protocol for lung IVM that utilizes a thoracic suction window to stabilize the lung for acquiring stable images.

Occipital-synarcual joint mobility in ratfishes (Chimaeridae) and its possible adaptive role.

The neurocranial elevation generated by axial muscles is widespread among aquatic gnathostomes. The mechanism has two functions: first, it contributes to the orientation of the mouth gape, and second, it is involved in suction feeding. To provide such mobility, anatomical specialization of the anterior part of the vertebral column has evolved in many fish species. In modern chimaeras, the anterior part of the vertebral column develops into the synarcual. Possible biological roles of the occipital-synarcual joint have not been discussed before. Dissections of the head of two species of ratfishes (Chimaera monstrosa and Chimaera phantasma) confirmed the heterocoely of the articulation surface between the synarcual and the neurocranium, indicating the possibility of movements in the sagittal and frontal planes. Muscles capable of controlling the movements of the neurocranium were described. The m. epaxialis is capable of elevating the head, the m. coracomandibularis is capable of lowering it if the mandible is anchored by the adductor. Lateral flexion is performed by the m. lateroventralis, for which this function was proposed for the first time. The first description of the m. epaxialis profundus is given, its function is to be elucidated in the future. Manipulations with joint preparations revealed a pronounced amplitude of movement in the sagittal and frontal planes. Since chimaeras generate weak decrease in pressure in the oropharyngeal cavity when sucking in prey, we hypothesised the primary effect of neurocranial elevation, in addition to the evident lateral head mobility, is accurate prey targeting.

Octopus-Inspired Soft Robot for Slow Drug Release.

Octopus tentacles are equipped with numerous suckers, wherein the muscles contract and expel air, creating a pressure difference. Subsequently, when the muscular tension is released, objects can be securely adhered to. This mechanism has been widely employed in the development of adhesive systems. However, most existing octopus-inspired structures are passive and static, lacking dynamic and controllable adhesive switching capabilities and excellent locomotion performance. Here, we present an octopus-inspired soft robot (OISR). Attracted by the magnetic gradient field, the suction cup structure inside the OISR can generate a strong adsorption force, producing dynamically controllable adsorption and separation in the gastrointestinal (GI) tract. The experimental results show that the OISR has a variety of controllable locomotion behaviors, including quick scrolling and rolling motions, generating fast locomotion responses, rolling over gastric folds, and tumbling and swimming inside liquids. By carrying drugs that are absorbable by GI epithelial cells to target areas, the OISR enables continuous drug delivery at lesions or inflamed regions of the GI tract. This research may be a potential approach for achieving localized slow drug release within the GI tract.

Suction versus non-suction drainage strategy after uniportal thoracoscopic lung surgery: a prospective cohort study.

Background: The postoperative outcomes of suction drainage versus non-suction drainage after uniportal video-assisted thoracoscopic surgery (UniVATS) come with little consensus. This study aimed to prospectively compare the postoperative outcomes of suction drainage versus non-suction drainage in patients who underwent UniVATS. Methods: Between October 2022 and January 2023, patients undergoing UniVATS were prospectively enrolled. The choice of drainage strategy (suction or non-suction) was at the surgeon's discretion. The primary outcome was chest tube duration, with secondary outcomes including postoperative drainage volume, pain scores, postoperative complications, length of hospital stay, and hospitalization cost. Baseline characteristics and postoperative outcomes were compared. Univariable and multivariable analyses were used to identify risk factors for postoperative outcomes. Results: A total of 206 patients were enrolled in this study, with 103 patients in each group. Baseline characteristics were well-balanced. The chest tube duration did not significantly differ between the two groups. However, suction drainage exhibited a significantly lower total drainage volume compared to non-suction drainage (280.00 vs. 400.00 mL, P=0.03). Suction drainage was associated with a significantly shorter postoperative hospital stay (3.00 vs. 4.00 days, P<0.001) and lower pain score on the second postoperative day (POD). Multivariable analyses also confirmed that suction drainage was significantly correlated with a lower total drainage volume and a shorter postoperative hospital stay. Conclusions: These findings suggested that the suction drainage was superior to non-suction drainage in terms of postoperative drainage volume and length of hospital stay in patients undergoing UniVATS.

Retrograde Intrarenal Surgery for Lithiasis Using Suctioning Devices: A Shift in Paradigm?

New suction endoscopes, ureteral access sheaths (UAS) and catheters aim to improve the efficacy of flexible ureteroscopy and optimize its safety. Suction UAS with non-flexible tips have shown promising results, especially in maintaining low intrarenal pressure, but also in removing small debris and reducing the "snow globe" effect. In addition, suctioning UAS with a flexible tip offers the advantage of being able to be navigated through the pyelocaliceal system to where the laser lithotripsy is performed. It can also remove small stone fragments when the flexible ureteroscope is retracted, using the Venturi effect. Direct in-scope suction (DISS) involves aspirating dust and small stone debris through the working channel of a flexible ureteroscope, thus regulating intrarenal pressure and improving visibility. Steerable aspiration catheters are other devices designed to increase stone clearance of the pyelocaliceal system. They are inserted under fluoroscopic guidance into every calyx after retraction of the flexible ureteroscope, alternating irrigation and aspiration to remove dust and small gravels. Combining flexible-tip suction UAS and the DISS technique may offer some advantages worth evaluating. The advantage of using these instruments to achieve a low intrarenal pressure was demonstrated. The true practical impact on the long-term stone-free status is a matter requiring further studies.

Assessment of Effectiveness and Safety of Aspiration-Assisted Nephrostomic Access Sheaths in PCNL and Intrarenal Pressures Evaluation: A Systematic Review of the Literature.

Background: Different suction-assisted nephrostomic sheaths have been developed for percutaneous nephrolithotomy (PCNL). Objectives: (1) To examine PCNL techniques performed with different aspiration-assisted sheaths (Clear Petra® sheath, Superperc, SuperminiPCNL, and a miniPCNL patented sheath), with specific regard to effectiveness and safety outcomes in adult and paediatric patients; (2) to extrapolate intrarenal pressure (IRP) data during these procedures. Methods: A systematic literature search was performed in accordance with PRISMA guidelines. Relevant articles up to 8 February 2024 were included. Results: Twenty-five studies were selected, thirteen retrospective and twelve prospective. The use of four different aspirating sheaths for miniPCNL was reported: Clear Petra® sheath, Superperc, SuperminiPCNL, and a miniPCNL patented sheath. Stone free rates (SFRs) across techniques ranged from 71.3% to 100%, and complication rates from 1.5% to 38.9%. Infectious complication rates varied from 0 to 27.8% and bleeding complication rates from 0 to 8.9%. Most complications were low grade ones. The trend among studies comparing aspiration- and non-aspiration-assisted miniPCNL was towards equivalent or better SFRs and lower overall infectious and bleeding complication rates in suction techniques. Operation time was consistently lower in suction procedures, with a mean shortening of the procedural time of 19 min. Seven studies reported IRP values during suction miniPCNL. Two studies reported satisfactory SFRs and adequate safety profiles in paediatric patient cohorts. Conclusions: MiniPCNL with aspirating sheaths appears to be safe and effective in both adult and paediatric patients. A trend towards a reduction of overall infectious and bleeding complications with respect to non-suction procedures is evident, with comparable or better SFRs and consistently shorter operative times. The IRP profile seems to be safe with the aid of aspirating sheaths. However, high quality evidence on this topic is still lacking.