Evaluation of the impact and need for use of a safety guidewire during ureteroscopy

Journal of Endourology
Jonathan A EandiRoger K Low

Abstract

The routine use of a "safety" guidewire adjacent to the ureteroscope during upper tract endoscopy is advocated in surgical texts and by many endourologists. Our experience has led us to theorize that a safety guidewire complicates ureteroscopy by providing resistance to introduction of the endoscope and by creating an obstruction to ureteroscopic instrumentation. To examine our theory, we developed a porcine animal model to evaluate the impact of the presence of a safety guidewire and reviewed our clinical experience, which routinely does not use a safety guidewire during ureteroscopy. An ex vivo model was created using the excised urinary tract of freshly slaughtered pigs. The forces needed to advance both a semirigid and flexible ureteroscope in the ureter were measured with and without the presence of a 0.035-inch safety guidewire. The clinical records of all patients undergoing ureteroscopy over a 4-year period were reviewed. On average, an additional 12 and 20 g of force were needed to introduce the semirigid and flexible ureteroscope when a guidewire was present. For the chosen study period, 361 patients underwent ureteroscopic procedures without the placement of a safety guidewire. No patient experienced an intraoperativ...Continue Reading

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Citations

Sep 15, 2010·Journal of Endourology·Rian J DicksteinDavid S Wang
Jan 21, 2011·Journal of Endourology·Roger K Low
Nov 19, 2011·Journal of Endourology·Sutchin R PatelStephen Y Nakada
Jun 26, 2013·Journal of Endourology·Øyvind UlvikNils M Ulvik
Sep 10, 2011·Therapeutic Advances in Urology·Rakesh Khanna, Manoj Monga
Apr 15, 2014·Der Urologe. Ausg. A·T Knoll, G Wendt-Nordahl
Feb 3, 2016·Urology Annals·Mahmoud AlameddineAnmar A Nassir
Feb 11, 2015·Urology·Shubha DeManoj Monga
Jun 15, 2016·Journal of Endourology·Rahul DuttaRalph V Clayman
Oct 5, 2017·Revista da Associação Médica Brasileira·Wilson Rica MolinaAlex Meller
Dec 1, 2017·Urolithiasis·José Manuel Reis Santos
Aug 16, 2012·Scandinavian Journal of Urology·Oyvind Ulvik, Nils M Ulvik

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