PubMed · 8153738
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C Upson, K Kirby. 1994. Backloading made easy.. https://pubmed.ncbi.nlm.nih.gov/8153738/
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Ureteral stenting is a procedure of daily routine. There are however cases in which cystoscopic placement of a stent fails despite various technical aids. Percutaneous nephrostomy is usually performed in those patients. In some cases however it is no reasonable alternative. For these special cases we used a combined antegrade/retrograde technique consisting in antegrade guide wire insertion followed by retrograde ureteral stenting. In 8 of 12 cases it was finally possible to insert a ureteral stent with this method. To our mind this technique should be applied when other attempts of stenting have failed and percutaneous nephrostomy is no reasonable alternative.
The use of a new device is described that prevents inadvertent dislodgment of a filiform introduced through a pinpoint urethral stricture or traumatized urethra during endoscopy. The device is easily autoclaved and is reusable.
An electromyographical field study was performed in the operating theatre on four surgeons during 15 urological operations. In the course of the operations two endoscopic techniques were applied alternately: (1) direct endoscopy, and (2) monitor endoscopy. During direct endoscopy the surgeon looks into the urethra and the bladder via an endoscope. In monitor endoscopy, by contrast, the operating area is observed via a video system consisting of a camera mounted on top of the endoscope and a monitor. During the operations surface electromyograms were derived from both trapezius muscles, the right deltoideus muscle and the left erector spinae muscle. An activity code describing the surgeons' activity was additionally recorded. Analysis of the activity recording reveals that the monitor endoscopic method is preferred in the first third of the operations, whereas preference is given to the direct method in the last third. The electromyographical measurements indicate that during monitor endoscopy the myoelectrical activity of both trapezius muscles and of the right deltoideus muscle is significantly reduced in comparison with the activity for the direct endoscopic technique. A significant influence of the surgical technique on the myoelectrical activity could not be established for the erector spinae muscle. The electromyographical findings reveal that the activity of the shoulder musculature required for the maintenance of the posture and the performance of the operation is significantly lower in monitor endoscopy than in direct endoscopy. Consequently, a clear reduction in muscular strain can be achieved during the performance of endoscopic operations in urology if a video system is employed.