WCE 2017: The Impact of Forces Applied during Ureteral Access Sheath Deployment on Ureteral Injury in a Porcine Model

Vancouver, Canada (UroToday.com) Dr. Kamaljot Kaler, assistant clinical professor from University of California, Irvine presented a novel device used to measure the impact force of ureteral access sheath (UAS) deployment.  

Concerns exist over possible ureteral injury during UAS deployment. Dr. Kaler’s team developed the Ureteral Access Sheath Force Sensor (UAS-FS) at UC Irvine (UCI) in order to transmit real-time force data to an Android tablet during access sheath deployment. In their pilot, porcine study, they used the UCI UAS-FS to evaluate the force threshold that results in splitting of the ureteral urothelium.  

In their study, they found no ureteral injury at ≤ 4 Newtons (N), but as UAS size increased, as expected, they identified greater force over-time and larger peak forces. They experienced their first ureteral injury at 8 N in the right ureter and at 10 N in the left ureter.  

From this they concluded that the UC Irvine Force Sensor can reliably measure force while deploying a UAS. Initial ureteral injury occurred at forces > 8 N, and they are conducting a clinical study using this device, ensuring that they below the > 8 N during UAS deployment. This novel machine holds promise for minimizing ureteral injury in the future. 

Presented by: Kamaljot S. Kaler 

Authors: Kamaljot S. Kaler, Roshan M. Patel, Renai Yoon, Daniel J. Lama, Christina Hwang, Zhamshid Okhunov, Michael Klopfer, Jaime Landman, Ralph V. Clayman  
Affiliation: Department of Urology, University of California, Irvine  

Written by: Egor Parkhomenko, Department of Urology, University of California-Irvine Medical at the 35th World Congress of Endourology– September 12-16, 2017, Vancouver, Canada