Acucise™ endopyelotomy in a porcine model: procedure standardization and analysis of safety and immediate efficacy

Acucise™ endopyelotomy in a porcine model: procedure standardization and analysis of safety and immediate efficacy

Author Andreoni, Cássio Autor UNIFESP Google Scholar
Srougi, Miguel Autor UNIFESP Google Scholar
Ortiz, Valdemar Autor UNIFESP Google Scholar
Clayman, Ralph V. Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
University of California Division of Urology
Abstract PURPOSE: The study here presented was done to test the technical reliability and immediate efficacy of the Acucise device using a standardized technique. MATERIALS AND METHODS: 56 Acucise procedures were performed in pigs by a single surgeon who used a standardized technique: insert 5F angiographic catheter bilaterally up to the midureter, perform retrograde pyelogram, Amplatz super-stiff guidewire is advanced up to the level of the renal pelvis, angiographic catheters are removed, Acucise catheter balloon is advanced to the ureteropelvic junction (UPJ) level, the super-stiff guide-wire is removed and the contrast medium in the renal pelvis is aspirated and replaced with distilled water, activate Acucise at 75 watts of pure cutting current, keep the balloon fully inflated for 10 minutes, perform retrograde ureteropyelogram to document extravasation, remove Acucise catheter and pass an ureteral stent and remove guide-wire. RESULTS: In no case did the Acucise device present malfunction. The electrocautery activation time was 2.2 seconds (ranging from 2 to 4 seconds). The extravasation of contrast medium, visible by fluoroscopy, occurred in 53 of the 56 cases (94.6%). In no case there was any evidence of intraoperative hemorrhage. CONCLUSIONS: This study revealed that performing Acucise endopyelotomy routinely in a standardized manner could largely preclude intraoperative device malfunction and eliminate complications while achieving a successful incision in the UPJ. With the guidelines that were used in this study, we believe that Acucise endopyelotomy can be completed successfully and safely in the majority of selected patients with UPJ obstruction.
Keywords kidney pelvis
ureteral obstruction
Acucise catheter
surgical procedures
minimally invasive
Language English
Date 2004-02-01
Published in International braz j urol. Sociedade Brasileira de Urologia, v. 30, n. 1, p. 59-65, 2004.
ISSN 1677-5538 (Sherpa/Romeo)
Publisher Sociedade Brasileira de Urologia
Extent 59-65
Access rights Open access Open Access
Type Article
SciELO ID S1677-55382004000100013 (statistics in SciELO)

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