San Diego, CA USA (UroToday.com) Use of the triangulated method during a percutaneous renal access (PRA) procedure may result in unintended mediolateral deviation of the Chiba needle while under oblique fluoroscopy. To prevent this incident from occurring, Dr. Tawfik and colleagues evaluated a device aimed to stabilize the needle during the initial target of the desired caylx.
Four junior urologists completed a total of 40 PRA cases, 20 with device assistance and 20 without device assistance. The device contains a radiolucent cylinder and has a longitudinal tunnel that allows the Chiba needle to pass through. Steps during a PRA include aligning the tunnel with the desired calyx, fixing the cylinder to the patient, and monitoring the puncture while under oblique fluoroscopy. Fluoroscopic time (FT) for entering into the calyx, number of re-adjustment trials (NRATs) and complications related to access was measured.
In comparison to the cases without device-assistance, cases using the device were shown to have reduced mean FT (47± 10.7 sec vs. 76.2± 14.7 sec) and median NRATs (0 trials vs. 4 trials). Amongst PRA-failures, in which a mentor completed the remainder of the procedure, 5% occurred with device assistance and 25% occurred without device assistance. The authors concluded that during a triangulated PRA, the device aided junior urologists in the stabilization of the Chiba needle and minimized or completely eliminated the occurrence of mediolateral deviation while targeting the calyx.
Presented By: Ahmad Tawfik, MD
Written By: Brittany Uribe, BS; Junior Specialist, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA