British Journal of Urology (1996), 77, 151 POINT OF TECHNIQUE Using the ‘pusher first’ technique to facilitate insertion of J-J stent guidewire J. McLOUGHLIN and P.J. O’BOYLE Department of Urology, Musgrove Park Hospital, Taunton, UK ment, the pusher is withdrawn and used in the usual Indications manner to advance the J-J stent. Open-ended J-J stents require initial passage of a flexible tipped guidewire over which the stent is rail-roaded into Advantages the ureter. It can be difficult to direct the guidewire into the ureteric orifice when the end of wire falls off the This technique facilitates both the passage of floppy- tipped guidewires using the Albaran bridge deflecting deflecting mechanism. This technique overcomes the problem. mechanism and also avoids kinking the end of the guidewire, as occurs after prolonged attempted manipulation. Technique Inserting the pusher first and aligning it in the axis of the ureteric orifice effectively produces a tunnel guide Authors which can be positioned either immediately adjacent to, J. McLoughlin, MS, FRCSUrol, formerly Senior Registrar, now or at any desired position in relation to, the ureteric Consultant Urologist, West Suffolk Hospital, Bury St Edmunds orifice. The pusher should not be pushed in too far. The IP33 2QZ, UK. guidewire is then inserted through the lumen of the P.J. O’Boyle, ChM, FRCS, Consultant Urologist. Correspondence: Mr J. McLoughlin. pusher and up to the ureteric orifice. After wire place- 151 © 1996 British Journal of Urology

Using the ‘pusher first’ technique to facilitate insertion of J-J stent guidewire

Download PDF Report

Upload
j-mcloughlin
View
216
Download
2

Embed Size (px)

Citation preview

Page 1: Using the ‘pusher first’ technique to facilitate insertion of J-J stent guidewire

British Journal of Urology (1996), 77, 151

P OI N T OF T E C H NI QU E

Using the ‘pusher first’ technique to facilitate insertion ofJ-J stent guidewireJ . M c LO UGH LIN and P .J. O’ BOYLEDepartment of Urology, Musgrove Park Hospital, Taunton, UK

ment, the pusher is withdrawn and used in the usualIndicationsmanner to advance the J-J stent.

Open-ended J-J stents require initial passage of a flexibletipped guidewire over which the stent is rail-roaded into Advantagesthe ureter. It can be difficult to direct the guidewire intothe ureteric orifice when the end of wire falls off the This technique facilitates both the passage of floppy-

tipped guidewires using the Albaran bridge deflectingdeflecting mechanism. This technique overcomes theproblem. mechanism and also avoids kinking the end of the

guidewire, as occurs after prolonged attemptedmanipulation.Technique

Inserting the pusher first and aligning it in the axis ofthe ureteric orifice effectively produces a tunnel guide Authorswhich can be positioned either immediately adjacent to, J. McLoughlin, MS, FRCSUrol, formerly Senior Registrar, nowor at any desired position in relation to, the ureteric Consultant Urologist, West Suffolk Hospital, Bury St Edmundsorifice. The pusher should not be pushed in too far. The IP33 2QZ, UK.guidewire is then inserted through the lumen of the P.J. O’Boyle, ChM, FRCS, Consultant Urologist.

Correspondence: Mr J. McLoughlin.pusher and up to the ureteric orifice. After wire place-