TITLE

'Pencil tip' metallic screw dilator: A new cost effective and safe device for single step percutaneous renal access

AUTHOR(S)
Dalela, D.
PUB. DATE
October 2008
SOURCE
Indian Journal of Urology;Supplement1, Vol. 24, pS46
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Introduction: A variety of dilatation systems are available for percutaneous renal access. We innovated a metallic .Pencil Tip. screw dilator for one step dilatation. Aim: A study was done to campare its effectiveness, safety and cost with Teflon dilators and metallic telescopic dilators. Materials and Methods: The device comprises two components . First being a screw dilator which is made up of steel (tip portion . solid, shaft . hollow) and the second, a club ended 6F guide rod. The tip of dilator is pencil tip shaped, having fine spiral ridges grooved at a distance of 1.5 mm. The rear end of dilator has a non slippery grip. After the guide wire and the rod are in place, the screw dilator is advanced by using a gentle screwing action and inward push under fluoro-guidance. A prospective, randomized comparative study was undertaken by a single surgeon to assess the feasibility and safety of new screw dilator. The study included 31 patients undergoing PCNL and patients were divided into 3 groups depending upon the whether metallic screw dilator, fascial dilatation or metallic telescopic dilator was used Primary outcomes compared were average tract formation time, time to achieve clear vision, postoperative haemoglobin drop, transfusion rate, vascular complications and cost. Results: There were 11, 10, and 10 patients in group 1, 2, and 3 respectively. The patients in all the groups were age and disease matched. The Average tract formation time and time to achieve clear vision was shorter and the cost was lower for patients in group 1. No significant difference was seen in the other variables analyzed. Conclusion: The new dilatation system developed by us saves operative time, is highly economical and easy to use. It does not increase the complication rate over that reported for other dilatation systems and maintains its efficacy during repeated sterilization and operative use.
ACCESSION #
34754688

 

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