Department of Urology, Sixth Affiliated Hospital of Jinan University, Dongguan, China.
Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
Urology. 2023 Sep;179:204-205. doi: 10.1016/j.urology.2023.06.009. Epub 2023 Jun 20.
Retrograde intrarenal surgery (RIRS) is one of the primary treatments for renal stones. The ureteral access sheath (UAS) was widely used in RIRS. The aim of this paper is to introduce a new UAS, the distal active flexible vacuum-assisted ureteral access sheaths (DAFV-UAS), for the renal calculus during RIRS.
A 56-year-old female presented to the outpatient clinics of our hospital with a left renal lower calyx stone. Abdominal CT demonstrated that the left kidney's lower calyx stone size was 10.54 ×10.38 mm, and the mean Hounsfield density was 965HU. After adequate anti-infective treatment, the DAFV-UAS was used in RIRS. No perioperative complications were observed. The left renal stone had been cleared completely.
The DAFV-UAS (10/12.5 Fr, 38 cm, creek, Jiangsu, China) includes a good flexibility and deformability tube at the tip, about 10 cm long. It has an active bending function, negative pressure suction function, and the function of convenient flexible ureteroscopy (f-URS) entry and exit of the ureter. In this case, the f-URS adopted a 7.5 Fr single-use digital f-URS. The Irrigation method was automated irrigation system, and the flow was 30 mL/min. The suction level was 0.02mpa. With the help of DAFV-UAS, the field of view is always clean, the small gravel particles can be sucked out from the sheath gap, and the larger gravel particles are sucked out by withdrawing the scope intermittently.
DAFV-UAS is a promising new device which allows for negative pressure suction directed right at a renal stone and efficient and effective stone clearance.
经皮肾镜取石术（RIRS）是治疗肾结石的主要方法之一。输尿管导入鞘（UAS）在 RIRS 中得到了广泛应用。本文旨在介绍一种新的 UAS，即远端主动灵活的负压辅助输尿管导入鞘（DAFV-UAS），用于 RIRS 中的肾结石。
一名 56 岁女性因左肾结石就诊于我院门诊。腹部 CT 显示左肾结石下盏结石大小为 10.54×10.38mm，平均 Hounsfield 密度为 965HU。经过充分的抗感染治疗后，采用 DAFV-UAS 行 RIRS。无围手术期并发症发生。左肾结石完全清除。
DAFV-UAS（10/12.5Fr，38cm，creek，江苏）包括一个良好的柔韧性和可变形的尖端管，约 10cm 长。它具有主动弯曲功能、负压抽吸功能以及方便软性输尿管镜（f-URS）进出输尿管的功能。在本例中，采用了 7.5Fr 一次性使用数字 f-URS。冲洗方法为自动化冲洗系统，流量为 30mL/min。抽吸水平为 0.02mpa。在 DAFV-UAS 的帮助下，视野始终保持清洁，可以从鞘间隙吸出小碎石颗粒，并且通过间歇性地撤回镜体可以吸出较大的碎石颗粒。
DAFV-UAS 是一种很有前途的新型设备，可以对肾结石进行直接负压抽吸，从而实现高效、有效的结石清除。
