MP79-06 COMPARISON OF NEPHROSTOMY TECHNIQUES IN THE PORCINE KIDNEY: RETROGRADE LASER ENDOSCOPIC X-RAY-GUIDED INTRARENAL TRACT (LEXIT) VERSUS RETROGRADE LAWSON ROCKET WIRE ACCESS VERSUS STANDARD NEPHROSTOMY NEEDLE ANTEGRADE ACCESS (2019)

You have accessJournal of UrologyStone Disease: Surgical Therapy VI (MP79)1 Apr 2019MP79-06 COMPARISON OF NEPHROSTOMY TECHNIQUES IN THE PORCINE KIDNEY: RETROGRADE LASER ENDOSCOPIC X-RAY-GUIDED INTRARENAL TRACT (LEXIT) VERSUS RETROGRADE LAWSON ROCKET WIRE ACCESS VERSUS STANDARD NEPHROSTOMY NEEDLE ANTEGRADE ACCESS Kamaljot Kaler*, Vinay Cooper, Mitchell O'Leary, Zachary Valley, Thomas Lee, Roshan Patel, Jaime Landman, and Ralph Clayman Kamaljot Kaler*Kamaljot Kaler* More articles by this author , Vinay CooperVinay Cooper More articles by this author , Mitchell O'LearyMitchell O'Leary More articles by this author , Zachary ValleyZachary Valley More articles by this author , Thomas LeeThomas Lee More articles by this author , Roshan PatelRoshan Patel More articles by this author , Jaime LandmanJaime Landman More articles by this author , and Ralph ClaymanRalph Clayman More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000557358.67766.baAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Laser Endoscopic X-ray-guided Intrarenal Tract (LEXIT) is a recently described retrograde access technique for creating a percutaneous nephrostomy using the Holmium laser. Herein, we compared the feasibility and safety of LEXIT with the retrograde Lawson rocket wire technique and standard antegrade 18-gauge nephrostomy needle access in a porcine kidney. METHODS: Seven pigs underwent nephrostomy accesses with simultaneous laparoscopic vision at 5 mmHg pressure. For each kidney, the aforementioned three access methods were randomized. The following data were collected: access time, bleeding severity (Scale: 1=no bleeding – 10=severe bleeding), bleeding duration, calyceal point of entry, and surgeon comfort with the technique (Scale: 1=very easy - 10=very difficult). Analysis of variance was performed to examine the differences among the 3 access methods. RESULTS: A total of 73 accesses were completed with an average of five nephrostomy tracts per kidney. The LEXIT access time was significantly faster than the nephrostomy needle or Lawson puncture wire (8.4, 63, 21 seconds (s), respectively, p<0.002). Bleeding intensity and duration were significantly lower with the Lawson wire (0.0, 0.0 s), versus LEXIT (2.1, 58.6 s) and the nephrostomy needle (3.4, 110.5 s) (Table 1). LEXIT was rated as in the easiest method for acquiring access within all calyces: upper pole (p=0.003), interpolar calyces (p<0.001), and lower pole (p<0.006) (Table 2). CONCLUSIONS: In the in vivo porcine kidney, endoscopic-guided retrograde holmium Laser Endoscopic X-ray-guided Intrarenal Tract (LEXIT) creation provided the fastest access times and greatest ease of access to the upper and interpolar calyces. Bleeding during LEXIT was significantly less than standard antegrade nephrostomy needle access. Source of Funding: none Calgary, Canada; Orange, CA© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e1153-e1154 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kamaljot Kaler* More articles by this author Vinay Cooper More articles by this author Mitchell O'Leary More articles by this author Zachary Valley More articles by this author Thomas Lee More articles by this author Roshan Patel More articles by this author Jaime Landman More articles by this author Ralph Clayman More articles by this author Expand All Advertisement PDF downloadLoading ...