Comparative study of irrigation efficiency during HoLEP and morcellation
We investigated the safety of and effective irrigation methods for holmium laser enucleation of the prostate (HoLEP) and tissue morcellation with and without using a lure lock cock with three companies’ endoscopes. Furthermore, the flow rates of the three companies’ irrigation tubes were compared....
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| Published in | Japanese Journal of Endourology Vol. 34; no. 2; pp. 350 - 355 |
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| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japanese Society of Endourology
2021
日本泌尿器内視鏡学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2186-1889 2187-4700 |
| DOI | 10.11302/jsejje.34.350 |
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| Abstract | We investigated the safety of and effective irrigation methods for holmium laser enucleation of the prostate (HoLEP) and tissue morcellation with and without using a lure lock cock with three companies’ endoscopes. Furthermore, the flow rates of the three companies’ irrigation tubes were compared. The flow rate exceeded 500 mL per minute for all manufacturers on performing HoLEP. In the morcellation setting, the presence of a lure lock cock did not affect the flow rate. The inflow rate of the irrigation port of the nephroscope in single route was lower than that of the outer sheath. The irrigation tube with the highest flow rate was had a large inside diameter and four connecting tubes. It is important to consider the difference in flow rates due to the difference in connection routes of an endoscope and choose an efficient irrigation route using a lure lock cock. |
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| AbstractList | We investigated the safety of and effective irrigation methods for holmium laser enucleation of the prostate (HoLEP) and tissue morcellation with and without using a lure lock cock with three companies’ endoscopes. Furthermore, the flow rates of the three companies’ irrigation tubes were compared. The flow rate exceeded 500 mL per minute for all manufacturers on performing HoLEP. In the morcellation setting, the presence of a lure lock cock did not affect the flow rate. The inflow rate of the irrigation port of the nephroscope in single route was lower than that of the outer sheath. The irrigation tube with the highest flow rate was had a large inside diameter and four connecting tubes. It is important to consider the difference in flow rates due to the difference in connection routes of an endoscope and choose an efficient irrigation route using a lure lock cock. We investigated the safety of and effective irrigation methods for holmium laser enucleation of the prostate (HoLEP) and tissue morcellation with and without using a lure lock cock with three companies’ endoscopes. Furthermore, the flow rates of the three companies’ irrigation tubes were compared. The flow rate exceeded 500 mL per minute for all manufacturers on performing HoLEP. In the morcellation setting, the presence of a lure lock cock did not affect the flow rate. The inflow rate of the irrigation port of the nephroscope in single route was lower than that of the outer sheath. The irrigation tube with the highest flow rate was had a large inside diameter and four connecting tubes. It is important to consider the difference in flow rates due to the difference in connection routes of an endoscope and choose an efficient irrigation route using a lure lock cock. holmium laser enucleation of the prostate (HoLEP) およびモーセレーションの安全かつ有効な灌流方法を検討するために, 国内で使用されている3社のHoLEP用内視鏡の灌流量をルアロックコック使用の有無も含め測定した. また, 3社のイリゲーションチューブの流量も比較した. HoLEPの設定では各社とも500 mL／分以上の流量があり, また, ルアロックコックを用いても流量の低下はほとんどなかった. モーセレーション時に1ルートで腎盂鏡のイリゲーションポートから灌流を行うと外筒側に比べ流入量が少なかった. イリゲーションチューブは内径が大きいもの, 2連結よりも4連結で流量が多かった. HoLEPおよびモーセレーションを行う際は内視鏡の接続ルートの違いによる流量の差を考慮し, ルアロックコックを用いた効率の良い灌流方法を選択することが重要であると考えられた. |
| Author | Ishida, Takuya Hayashi, Kenjiro Shishido, Toshihide Aizawa, Taku Hashimoto, Takeshi Satake, Naoya Namiki, Kazunori Ohno, Yoshio |
| Author_FL | 大野 芳正 佐竹 直哉 宍戸 俊英 石田 卓也 林 建二郎 相澤 卓 橋本 剛 並木 一典 |
| Author_FL_xml | – sequence: 1 fullname: 宍戸 俊英 – sequence: 2 fullname: 石田 卓也 – sequence: 3 fullname: 橋本 剛 – sequence: 4 fullname: 佐竹 直哉 – sequence: 5 fullname: 並木 一典 – sequence: 6 fullname: 相澤 卓 – sequence: 7 fullname: 林 建二郎 – sequence: 8 fullname: 大野 芳正 |
| Author_xml | – sequence: 1 fullname: Ohno, Yoshio – sequence: 1 fullname: Hashimoto, Takeshi – sequence: 1 fullname: Hayashi, Kenjiro – sequence: 1 fullname: Ishida, Takuya – sequence: 1 fullname: Shishido, Toshihide – sequence: 1 fullname: Namiki, Kazunori – sequence: 1 fullname: Aizawa, Taku – sequence: 1 fullname: Satake, Naoya |
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| References | 2) Gilling PJ, Kennett K, Das AK, et al. (1998) Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation : an update on the early clinical experience. J Endourol 12 : 457-459 5) Elzayat EA, Elhilali MM (2006) Holmium laser enucleation of the prostate (HoLEP) : the endourologic alternative to open prostatectomy. Eur Urol 49 : 87-91 11) 平山貴博, 設楽敏也, 藤田哲夫, 他 (2010) Morcellationにおけるhandpiece反転法の有用性の実証. Jpn J Endourol ESWL 23 : 133-137 12) 設楽敏也, 賀本敏行 (2008) 前立腺肥大症の最新治療, HoLEP (1). Urol View 6 : 124-130 1) Gilling PJ, Cass CB, Cresswell MD, et al. (1996) Holmium laser resection of the prostate : preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology 47 : 48-51 6) Seki N, Tatsugami K, Naito S (2007) Holmium laser enucleation of the prostate : comparison of outcomes according to prostate size in 97 Japanese patients. J Endourol 21 : 192-196 9) Hwang J, Park S, Lee J (2010) Holmium laser enucleation of the prostate for benign prostatic hyperplasia : effectiveness, safety, and overcoming of the learning curve. Korean J Urol 51 : 919-924 13) Endo F, Shiga Y, Minagawa S, et al. (2010) Anteroposterior dissection HoLEP : a modification to prevent transient stress urinary incontinence. Urology 76 : 1451-1455 15) 三木 誠 (2003) 閉鎖神経反射を起こさない新TURシステム (TURis) の開発とその臨床応用. 日泌会誌 94 : 671-677 3) 中川 健 (2008) TUEB (Transurethral Enucleation with Bipolar : バイポーラーシステムを利用した経尿道的前立腺核出術) の手技. 泌外 21 : 783-787 14) 日本泌尿器科学会編 (2017) 男性下部尿路症状・前立腺肥大症診療ガイドライン. リッチヒルメディカル, 東京, pp. 135-145 10) Madsen PO, Naber KG (1973) The importance of the pressure in the prostatic fossa and absorption of irrigating fluid during transurethral resection of the prostate. J Urol 109 : 446-452 7) Ahyai S, Gilling P, Kaplan SA, et al. (2010) Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol 58 : 384-397 8) Shah HN, Mahjan AP, Hegde SS, et al. (2007) Peri-operative complications of holmium laser enucleation of the prostate : experience in the first 280 patients, and a review of literature. BJU Int 100 : 94-101 4) Elmansy HM, Kotb A, Elhilali MM (2011) Holmium laser enucleation of the prostate : Long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol 186 : 1972-1976 |
| References_xml | – reference: 10) Madsen PO, Naber KG (1973) The importance of the pressure in the prostatic fossa and absorption of irrigating fluid during transurethral resection of the prostate. J Urol 109 : 446-452 – reference: 1) Gilling PJ, Cass CB, Cresswell MD, et al. (1996) Holmium laser resection of the prostate : preliminary results of a new method for the treatment of benign prostatic hyperplasia. Urology 47 : 48-51 – reference: 4) Elmansy HM, Kotb A, Elhilali MM (2011) Holmium laser enucleation of the prostate : Long-term durability of clinical outcomes and complication rates during 10 years of followup. J Urol 186 : 1972-1976 – reference: 5) Elzayat EA, Elhilali MM (2006) Holmium laser enucleation of the prostate (HoLEP) : the endourologic alternative to open prostatectomy. Eur Urol 49 : 87-91 – reference: 2) Gilling PJ, Kennett K, Das AK, et al. (1998) Holmium laser enucleation of the prostate (HoLEP) combined with transurethral tissue morcellation : an update on the early clinical experience. J Endourol 12 : 457-459 – reference: 9) Hwang J, Park S, Lee J (2010) Holmium laser enucleation of the prostate for benign prostatic hyperplasia : effectiveness, safety, and overcoming of the learning curve. Korean J Urol 51 : 919-924 – reference: 8) Shah HN, Mahjan AP, Hegde SS, et al. (2007) Peri-operative complications of holmium laser enucleation of the prostate : experience in the first 280 patients, and a review of literature. BJU Int 100 : 94-101 – reference: 7) Ahyai S, Gilling P, Kaplan SA, et al. (2010) Meta-analysis of functional outcomes and complications following transurethral procedures for lower urinary tract symptoms resulting from benign prostatic enlargement. Eur Urol 58 : 384-397 – reference: 3) 中川 健 (2008) TUEB (Transurethral Enucleation with Bipolar : バイポーラーシステムを利用した経尿道的前立腺核出術) の手技. 泌外 21 : 783-787 – reference: 11) 平山貴博, 設楽敏也, 藤田哲夫, 他 (2010) Morcellationにおけるhandpiece反転法の有用性の実証. Jpn J Endourol ESWL 23 : 133-137 – reference: 6) Seki N, Tatsugami K, Naito S (2007) Holmium laser enucleation of the prostate : comparison of outcomes according to prostate size in 97 Japanese patients. J Endourol 21 : 192-196 – reference: 13) Endo F, Shiga Y, Minagawa S, et al. (2010) Anteroposterior dissection HoLEP : a modification to prevent transient stress urinary incontinence. Urology 76 : 1451-1455 – reference: 14) 日本泌尿器科学会編 (2017) 男性下部尿路症状・前立腺肥大症診療ガイドライン. リッチヒルメディカル, 東京, pp. 135-145 – reference: 12) 設楽敏也, 賀本敏行 (2008) 前立腺肥大症の最新治療, HoLEP (1). Urol View 6 : 124-130 – reference: 15) 三木 誠 (2003) 閉鎖神経反射を起こさない新TURシステム (TURis) の開発とその臨床応用. 日泌会誌 94 : 671-677 |
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| SubjectTerms | HoLEP irrigation luer lock cock morcellation モーセレーション ルアロックコック 灌流 |
| Title | Comparative study of irrigation efficiency during HoLEP and morcellation |
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