Abstract
Objective:
To demonstrate a step-by-step approach to ureteroscopy to treat renal and ureteral calculi, with an emphasis on instrumentation and technique.
Methods:
Procedures involved with ureteroscopy are outlined in chronological order. Consideration for the organization of operating room components are described, along with safety issues, risks, and procedural challenges. The proper choice and uses of guidewires for obtaining and maintaining access to the upper tract are explained, in addition to irrigation and fluoroscopic imaging methods. Concerns for using access sheaths are described, as well as necessary settings and procedures for holmium laser lithotripsy. Stone basket design considerations and techniques for removing stones are also summarized. Methods used for the coordination and manipulation of multiple instruments are described for both the surgeon and the assistant. Lastly, choice of ureteral stent size, and methods for the safe placement of ureteral stents are demonstrated.
Conclusions:
Ureteroscopy is a complex procedure, requiring the integration of multiple technologies and techniques. A step-wise organization and technique allows the surgical team to prepare for successful execution and optimizes the likelihood of a favorable patient outcome.
Runtime of video: 14 mins 9 secs
Keywords
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