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Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania

Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

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Page 1: Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

Prof. Petrisor GEAVLETE, MD, PhD.Razvan Multescu, MD, PhD.Bogdan Geavlete, MD, PhD.Saint John Emergency Clinical Hospital

Bucharest, Romania

Prof. Petrisor GEAVLETE, MD, PhD.Razvan Multescu, MD, PhD.Bogdan Geavlete, MD, PhD.Saint John Emergency Clinical Hospital

Bucharest, Romania

Page 2: Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

8/9.8F Wolf, 8 and 10F Storz, 8.5/9.9 F Olympus Endoeye digital semirigid ureteroscopes

Balistic, electrohydaulic or Ho:YAG laser lithotripters.

7.5F 7.5F 8.7F 8.5F 9.0F 9.5F 8.2F 8.0F

Improved visibilityImproved visibility

P.Geavlete, 2008 P.Geavlete, 2008 P.Geavlete, 2008 P.Geavlete, 2008 P.Geavlete, 2008

Page 3: Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

Intraoperative incidents (4.3%)

failure to negotiate de ureteral orifice (68 cases)failure to reach the calculi (237 cases)fixed stone baskets (69 cases)equipment damages (40 cases)double J stent malpositioning (12 cases)

All the incidents were dealt endoscopically, except one case of fixed basket that imposed open extraction.

Page 4: Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

Intraoperative complications (2.8%)lesions of the ureteral mucosa (167 cases)perforation (68 cases)bleeding (26 cases)ureteral avulsion (3 cases)extra-ureteral stone migration (12 cases)

All intraoperative complications were identified intraoperatively and

treated immediately Open surgery was necessary in only 5

cases.

Page 5: Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

P.Geavlete, 2009 P.Geavlete, 2007P.Geavlete, 2000

Lesions of the ureteral mucosa

Fixed stone baskets

Perforation

Page 6: Prof. Petrisor GEAVLETE, MD, PhD. Razvan Multescu, MD, PhD. Bogdan Geavlete, MD, PhD. Saint John Emergency Clinical Hospital Bucharest, Romania Prof. Petrisor

Due to technological advances and increased experience, the semirigid retrograde ureteroscopic treatment of ureteral lithiasis increased the efficacy, while the incidence of intraoperative complications decreased. Most of these complications are minor and can be managed by conservative approach.

CONCLUSIONSCONCLUSIONSCONCLUSIONSCONCLUSIONS


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