Wyner Lawrence M
Marshall University Joan C. Edwards School of Medicine, Huntington, WV.
Urology. 2018 Apr;114:245. doi: 10.1016/j.urology.2018.01.006. Epub 2018 Jan 17.
To place a suprapubic tube without using specialized instruments. Suprapubic cystostomy is a straightforward urological procedure, which nevertheless may become complicated if the equipment needed to perform the operation is unavailable. Nowadays, in most operating rooms, control of urological instruments has been taken away from a small cadre of dedicated urology nurses, and instead is delegated to a central sterilization department or is even outsourced, leading to an increased rate of instrument misplacement or breakage. Disposable kits are useful, but may not be stocked at all facilities. Hence, the tools needed by the urologist to perform suprapubic cystostomy may not be readily available when they are needed. This reality was the impetus for the development of the following technique for suprapubic tube placement, which relies only upon ordinary instruments.
A simple method is described for placing a suprapubic catheter using a curved Van Buren sound, a cystoscope, and a minor surgical set.
Not only is the operation is easy to do, but is also advantageous in that the catheter may be exchanged over a wire, if necessary, before the establishment of a suprapubic tract. The technique depends on the presence of an intact urethra; therefore, it is contraindicated in the setting of pelvic trauma.
This suprapubic cystostomy method may be used either as a primary technique or as a back-up procedure if the urologist's preferred instrumentation is not available.
在不使用专用器械的情况下放置耻骨上导尿管。耻骨上膀胱造瘘术是一种简单的泌尿外科手术,但如果没有手术所需的设备,可能会变得复杂。如今,在大多数手术室中,泌尿外科器械的管理已从小部分专业泌尿外科护士手中转移出去,转而委托给中央消毒部门,甚至外包出去,这导致器械误放或损坏的发生率增加。一次性套件很有用,但并非所有医疗机构都有库存。因此,泌尿外科医生进行耻骨上膀胱造瘘术所需的工具在需要时可能无法随时获得。这一现实促使我们开发了以下仅依靠普通器械进行耻骨上导尿管放置的技术。
描述了一种使用弯形范布伦探子、膀胱镜和小型手术器械套装放置耻骨上导尿管的简单方法。
该手术不仅操作简便,而且还有利于在耻骨上通道建立之前,如有必要可通过导丝更换导尿管。该技术取决于尿道是否完整;因此,在骨盆创伤的情况下是禁忌的。
如果泌尿外科医生首选的器械不可用,这种耻骨上膀胱造瘘术方法既可以作为主要技术使用,也可以作为备用程序。