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Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is…
INTRODUCTION: Urological surgery is estimated to be the third most common cause of iatrogenic-retained foreign bodies 1. PRESENTATION: A 76-year old man was undergoing a transurethral resection of bladder tumor with a 26-Ch continuous flow resectoscope (Karl Storz, Germany). Before starting resectio...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Sociedade Brasileira de Urologia
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837588/ https://www.ncbi.nlm.nih.gov/pubmed/30735339 http://dx.doi.org/10.1590/S1677-5538.IBJU.2018.0229 |
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author | Castellani, Daniele Gasparri, Luca Claudini, Redi Pavia, Maria Pia Branchi, Alessandro Dellabella, Marco |
author_facet | Castellani, Daniele Gasparri, Luca Claudini, Redi Pavia, Maria Pia Branchi, Alessandro Dellabella, Marco |
author_sort | Castellani, Daniele |
collection | PubMed |
description | INTRODUCTION: Urological surgery is estimated to be the third most common cause of iatrogenic-retained foreign bodies 1. PRESENTATION: A 76-year old man was undergoing a transurethral resection of bladder tumor with a 26-Ch continuous flow resectoscope (Karl Storz, Germany). Before starting resection, a detachment of resectoscope sheath tip was noted. The ceramic tip was free-floating in the bladder lumen, and it would not fit within the sheath, making direct extraction using the loop impossible. An attempt was made to break it with a stone punch, but it was unsuccessful due to impossibility of closing it in the branches. Therefore, we decided to fragment the tip with holmium laser (RevoLix®, LISA Laser products, Germany), using an 800-micron, front-firing fiber. Laser device was settled at with 2.5 J energy and 5 Hz frequency. Ceramic appeared very hard, but it was difficult to carry on breaking with this setting because of tip retropulsion. Then, laser setting was switched to lower energy and higher frequency (1 J and 13 Hz). This setting guaranteed the same power of 13 W, but with minimal retropulsion. RESULTS: Tip was fragmented against the posterior bladder wall in seven pieces, which were retrieved trough the outer sheath. A total 5.62 kJ were used to fragment it. At the end, superficial lesions of the posterior bladder wall were highlighted. Surgical time was 55 minutes. Patient was discharged home next day without problems. CONCLUSIONS: Holmium laser fragmentation is a safe and effective approach to remove foreign bodies from the bladder. |
format | Online Article Text |
id | pubmed-6837588 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Sociedade Brasileira de Urologia |
record_format | MEDLINE/PubMed |
spelling | pubmed-68375882019-12-05 Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… Castellani, Daniele Gasparri, Luca Claudini, Redi Pavia, Maria Pia Branchi, Alessandro Dellabella, Marco Int Braz J Urol Video Section INTRODUCTION: Urological surgery is estimated to be the third most common cause of iatrogenic-retained foreign bodies 1. PRESENTATION: A 76-year old man was undergoing a transurethral resection of bladder tumor with a 26-Ch continuous flow resectoscope (Karl Storz, Germany). Before starting resection, a detachment of resectoscope sheath tip was noted. The ceramic tip was free-floating in the bladder lumen, and it would not fit within the sheath, making direct extraction using the loop impossible. An attempt was made to break it with a stone punch, but it was unsuccessful due to impossibility of closing it in the branches. Therefore, we decided to fragment the tip with holmium laser (RevoLix®, LISA Laser products, Germany), using an 800-micron, front-firing fiber. Laser device was settled at with 2.5 J energy and 5 Hz frequency. Ceramic appeared very hard, but it was difficult to carry on breaking with this setting because of tip retropulsion. Then, laser setting was switched to lower energy and higher frequency (1 J and 13 Hz). This setting guaranteed the same power of 13 W, but with minimal retropulsion. RESULTS: Tip was fragmented against the posterior bladder wall in seven pieces, which were retrieved trough the outer sheath. A total 5.62 kJ were used to fragment it. At the end, superficial lesions of the posterior bladder wall were highlighted. Surgical time was 55 minutes. Patient was discharged home next day without problems. CONCLUSIONS: Holmium laser fragmentation is a safe and effective approach to remove foreign bodies from the bladder. Sociedade Brasileira de Urologia 2019-09-02 /pmc/articles/PMC6837588/ /pubmed/30735339 http://dx.doi.org/10.1590/S1677-5538.IBJU.2018.0229 Text en https://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Video Section Castellani, Daniele Gasparri, Luca Claudini, Redi Pavia, Maria Pia Branchi, Alessandro Dellabella, Marco Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… |
title | Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… |
title_full | Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… |
title_fullStr | Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… |
title_full_unstemmed | Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… |
title_short | Iatrogenic foreign body in urinary bladder: Holmium laser vs. Ceramic, and the winner is… |
title_sort | iatrogenic foreign body in urinary bladder: holmium laser vs. ceramic, and the winner is… |
topic | Video Section |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6837588/ https://www.ncbi.nlm.nih.gov/pubmed/30735339 http://dx.doi.org/10.1590/S1677-5538.IBJU.2018.0229 |
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