Coppinger S W, Lewis C A, Milroy E J
Department of Urology, St Peter's Hospital, London, UK.
Br J Urol. 1995 Jul;76(1):66-72. doi: 10.1111/j.1464-410x.1995.tb07834.x.
To design a practical system for non-invasively monitoring fluid balance during transurethral resection of the prostate (TURP) and other endoscopic procedures.
Load cell transducers are incorporated into a platform placed under the operating table. Output is passed to a digital weighmeter and then to a portable computer. The raw data is filtered using software written by the authors (CAL) and the output displayed both numerically and graphically on the computer screen. The device was tested under laboratory conditions and then assessed in the clinical setting.
The device proved stable in both the laboratory and clinical settings. Examples of the common patterns generated during TURP are presented. The prototype has been used routinely in our practice to warn the surgeon and anaesthetist of fluid overload and has been used to monitor fluid balance in several studies.
This instrument provides a practical method of monitoring total fluid balance during TURP. It can be used with either general or regional anaesthesia and provides information not otherwise available. It provides an early warning of significant changes in total fluid balance, particularly irrigant fluid absorption. Use of this device serves to prevent development of the TUR syndrome, a potentially fatal complication of endoscopic surgery. Our ultimate aim is to produce a refined version that is simple, compact and cheap enough to be used routinely in all urological theatres. The cost of a single episode of intensive care for a patient developing iatrogenic complications from irrigant absorption would offset the cost of such a device.
