MP22-17 COMBINED ROBOTIC FLEXIBLE URETERORENOSCOPY AND MINI PERCUTANEOUS LITHOTRIPSY IN SUPINE POSITION

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy I1 Apr 2016MP22-17 COMBINED ROBOTIC FLEXIBLE URETERORENOSCOPY AND MINI PERCUTANEOUS LITHOTRIPSY IN SUPINE POSITION Kemal Sarica, Nida Zafer Tokatli, Remzi Saglam, H. Gurdal Inal, Yildirim Yilmaz, and Anup Patel Kemal SaricaKemal Sarica More articles by this author , Nida Zafer TokatliNida Zafer Tokatli More articles by this author , Remzi SaglamRemzi Saglam More articles by this author , H. Gurdal InalH. Gurdal Inal More articles by this author , Yildirim YilmazYildirim Yilmaz More articles by this author , and Anup PatelAnup Patel More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.705AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Supine position is suitable for the combination of rigid or flexible ureterorenoscopy (fURS) and PCNL/mini PCNL in the same session. We use to use supine positon for the treatment of selected kidney stones. During the combination of manual fURS and PCNL keeping the fURS in the pelvis or upper ureter was not possible. When we need to reuse fURS it was necessary reinsertion and relocation of the stone. This condition was the time consuming method. In this study we used fURS with Avicenna Roboflex simultaneously with PCNL, to search availability and advantages. METHODS We used Roboflex for 18 cases of multi caliceal stones in the recent two years. During the combination treatment in supine position, after insertion of fURS in a classical way we connected the flexible device to the Roboflex and examined the pelvis or calices, planned stones treated by Roboflex and the tip of the fURS fixed 2cm distal of the ureteropelvic junction. We treated mostly large lower caliceal stones by mini PCNL and evacuated all of the fragments which are difficult to clear out spontaneously. During the treatment of planned pelvic or caliceal stones by miniPCNL, fURS device was waiting in the same position ready for reuse. After the mini PCNL we used the robotic fURS again, for recheck the calices and ureter for residual fragments or known stones, and if some stone fragments can found they were fragmented. RESULTS Roboflex, the robot for flexible ureteroscopy was very successfull during the combination treatment in supine position, Roboflex was very helpful to keep the fURS in place with fixed tip, by this way we introduced four targeted calices under endoscopic vision, without using an assistant. We analyzed patients the CT controls after 3 months. 14 patients were stone free. 4 patients had fragments less than 4mm. None of them have any damage of the kidney or urinary system. There was no any complication. Fever not exceeding one day was seen in 2 patients. CONCLUSIONS Robotic flexible ureterorenoscopy using Roboflex is helpful for the fURS during combination treatment of multicaliceal stones. Behind the other advantages of Roboflex, as we presented elsewhere, it saves the time and protect the fibers of fURS and prevent fatigue of the user. We need to analyze long term results. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e259 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Kemal Sarica More articles by this author Nida Zafer Tokatli More articles by this author Remzi Saglam More articles by this author H. Gurdal Inal More articles by this author Yildirim Yilmaz More articles by this author Anup Patel More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...