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Efficacy and Safety of Ultrasonic Longitudinal-Axis Vibration for the Reduction of Ureteral Access Sheath Insertion Force: A Randomized Controlled Trial in a Porcine Model

Authors
 Kyo Chul Koo  ;  Kwang Suk Lee  ;  Gyu Rang Min  ;  Hye Sun Lee  ;  Beom Jin Lim  ;  Ji Sup Kim  ;  Dong Wook Kim  ;  No-Cheol Park 
Citation
 Journal of Endourology, Vol.33(2) : 140-145, 2019 
Journal Title
 Journal of Endourology 
ISSN
 0892-7790 
Issue Date
2019
Keywords
force ; ultrasonic vibrations ; ureter ; ureteroscopy
Abstract
PURPOSE: Excessive bulking force during ureteral access sheath (UAS) placement may induce injury. The sliding friction between surfaces can be reduced with the application of ultrasonic vibration. We investigated the efficacy and safety of an ultrasonic vibration transducing device for reducing the maximal ureteral access sheath insertion force (UASIF). MATERIALS AND METHODS: A device was developed for transducing ultrasonic longitudinal-axis vibration onto the UAS at an adjustable amplitude and frequency while measuring the degree of UASIF. In the pilot study, six porcine models were used to investigate the optimal amplitude and frequency of vibration and to calculate sample size. Twelve porcine models were utilized in a randomized controlled trial. Resected ureters were pathologically evaluated for ureteral injury. RESULTS: The transduction of ultrasonic vibration at an amplitude of 0.04 g and a frequency of 18,000 Hz resulted in a maximal UASIF reduction of 36.4% (interquartile range 32.7-43.1). Maximal UASIF tended to decrease with increasing vibration frequency. No significant differences in UASIF reductions were observed according to amplitude. In the randomized controlled trial, the maximal UASIF reduction was 37.0% (interquartile range 21.4-44.2). Grade II injury was pathologically diagnosed in 8.3% (1/12) of the ureters in both groups. CONCLUSIONS: The transduction of ultrasonic longitudinal-axis vibration onto the UAS reduces maximal UASIF and does not harm the ureter. Reducing the velocity of sheath insertion may further reduce maximal UASIF.
Full Text
https://www.liebertpub.com/doi/full/10.1089/end.2018.0772
DOI
10.1089/end.2018.0772
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Koo, Kyo Chul(구교철) ORCID logo https://orcid.org/0000-0001-7303-6256
Lee, Kwang Suk(이광석) ORCID logo https://orcid.org/0000-0002-7961-8393
Lee, Hye Sun(이혜선) ORCID logo https://orcid.org/0000-0001-6328-6948
Lim, Beom Jin(임범진) ORCID logo https://orcid.org/0000-0003-2856-0133
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/171250
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