732
SILVA
ET AL.
FIG
of
1.
introduced
Cutting edge
diathermy probe
through
to the
FIG 3. The
channel of
5F renal catheter introduced
through working
8F
or 9.5F
ureteroscope.
ureteroscope.
or
CT. The
evaluation also included
of the
electric
The connection of the
ex¬
phy
cretory urography
tion
spiral
preoperative
(IVU),
ureterorenoscope.
probe
is
with
filtra¬
with furosemide.
was
is done
a
standard electric cable of
a
scintigraphy
glomerular
generator
using
rate
and
a
to which an
This device can be
(GFR), calculation,
cases,
renogram
ureteroresectoscope,
appropriate plug
adapted
working
five
In all
about 20% to
the GRF in the
the 5F
2).
hydronephrotic kidney
(Fig.
passed through
40% less than in the contralateral
and the
channel of the 8F or 9.5F
3).
kidney,
of
ureterorenoscope (Fig.
furosemide test was
nor strictures
sertion,
The incision is created in the
as described for the cold- or
sual
of
There were no cases
in¬
were
the
UPJ,
under vi¬
positive.
posterolateral
diathermy-knife
high
aspect
>
1.5 cm in
The
and all
incision,
length.
procedures
were
control.
is used in the cut mode with a
under
The
anesthesia,
accomplished
general
generator
patients
power
Be¬
first
the
left with double-J
for
2
of
60
the
and
solution
fluid.
stents
months.
50 to
sorbitol
as
W,
using
irrigant
cause of
cuts are not
bent
1),
Fig.
(see
and
slightly
very deep,
by
extremity
depth
cutting
final
of
in¬
so the
the
length
controlled
to reach the
direct vision and
and
cision is
aiming
AND
DISCUSSION
RESULTS
sequential
pyelography
fat in
a
peripelvic
periureteric
length
to
3
to the extent of the stricture.
There were no
dure was 30
The
time of
the
cm,
mean
up
according
complications.
and the
proce¬
ac¬
of
a
total
24
was
2
or
3
Among
minutes,
retrograde endopyelotomies performed
five were done this device
hospital stay
days,
from 1992 to
an 8F or 9.5F
to the
of hematuria. The 6-month
1998,
IVU
five
using
In these five cases
through
cording
degree
follow-up
and renal scan demonstrated no obstruction in
cases.
of
(Table
the
1),
rigid ureteroscope.
any
not
all done in 1997 and
it was
to
the 11.5F
the mean
is
8
months
will not
1998,
possible
cold
pass
(range
differ
Although
follow-up
results
only
in order to
a
the
4—12
(which
months),
perform
ureteroscope
is, however,
normal vessels
endopyelotomy
long-term
presumably
the
that we
There were no ab¬
from those obtained with the available
technique
crossing
prefer).
as confirmed
diathermy
cutting
the
UPJ,
as the
In our
knife incision
of incision is identical.
by arteriogra-
probes,
type
institution,
with
a
cold-
retrograde endopyelotomy
a
11.5F
after dilatation
using rigid
ureteroscope
with
a
double-J stent has been the first choice for the treatment
of
ble to
left the stent for
the
obstruction.
few
UPJ
in
a
it was not
However,
the 11.5F
cases,
In those
possi¬
we
cases,
made another
pass
ureteroscope.
and
usually
in
a
longer period
months.
attempt
in
these
more
following 3
recently,
However,
the home-made
cases,
we started
at
with
the
once
using
diathermy probe
we are
results. To manufacture the
good
probe,
considering
use of
a
4F renal catheter instead of the 5F catheter in order to
achieve better field as the tube allows
surgical
irrigation,
the
larger
channel around
the
the
of more fluid
passage
probe.
through
working
valid alternative
Acucise™,
there are other
the Rite-Cut electrode or the
such as
more
devices,
are
Although
which
gaining
and more
we think that
enthusiasts,
this home-made device is
retrograde endopyelotomy
as it
at
allows,
control and
FIG 2.
to
mounted and
to be connected using
advantageous,
with visual
Diathermy probe
ready
a
low
the
same success
1
and
tip
2
that connect
to
cost,
rate,
very
plugs
probe
generator;
generator.
3
naked
of
minimal
bent
probe.
morbidity.
Audibert
