Minimising the Risk of Endourologic Complications
When performing any medical procedure, it is the clinician’s responsibility to minimise the risk of complications wherever possible. This always involves meticulous assessment and treatment planning, with all scenarios considered to mitigate the chance of unfavourable events or outcomes. The equipment used during surgery is another factor that can influence clinical success.
With regards to endourologic procedures, minimising complications and enhancing the patient experience can influence the speed of discharge and recovery, as well as the patient’s overall experience. Take ureteroscopy as an example. Complications are often associated with a large stone burden and clinician experience. Also putting patients at risk are a history of ureteral surgery, stones of more than 5mm and dilatation of the proximal ureter, among other factors.i In addition, prolonged operative time is associated with lower chances of the patient being discharged on the same day without a post-operative stent. It also increases the risk of high-grade, infection-related complications.ii
To mitigate against these risks, clinicians will often consider a guidewire over the catheter and keeping the bladder empty. Small scopes may also be useful in avoiding dilatation of the ureter altogether.i
Another relevant endourologic procedure is cystoscopy, and while modern procedures are generally very safe, some complications are still possible. These tend to affect patients who are overweight and may include infection and bladder or urethral damage, as well as other issues associated with surgery in general, such as blood loss or a blood clot.iii
To reduce the risk of inadvertent internal damage during a cystoscopy – or any type of endourologic procedure – clinicians take steps to ensure that the surgery is as atraumatic as possible. New techniques and instruments have emerged in the sector designed to reduce scar size and pain, and to improve the recovery time for patients.iv Though some require more research across a wide range of indications, others have demonstrated several benefits in various surgical situations.
For instance, CystoAssist™ from Mediflex Surgical Products is a cutting-edge solution designed to enhance endourologic procedures and assist in mitigating complications. This advanced system incorporates innovative features that provide clinicians with a safer and more convenient approach. By establishing a stable working channel into the bladder or ureter, CystoAssist allows for quick setup and customisation to suit the specific requirements of each procedure while also aiming to reduce radiation exposure and prevent product waste and delays due to inadvertent droppage, all while saving time and cost.
CystoAssist not only excels in establishing a functional working channel into the bladder and ureter but can also provide stability and security for access sheaths and wires. Furthermore, it can be used to stabilise a ureteroscope to reduce fatigue.
One notable advantage of this modular platform is that it enables clinicians to work with both hands, eliminating the need for an assistant to hold the scope. Consequently, this minimises movement, reduces patient trauma, alleviates surgeon fatigue, and optimises the overall treatment time while upholding exceptional clinical standards.
If you wish to witness the improved workflow efficiency, enhanced treatment quality, and reduced risk of complications associated with endourological procedures, learn more about CystoAssist™ or Contact Us today.
i Jagtap J, Laddha A, Ganpule A, Desai MU. Minimizing complications in endourological surgery. Clinical Practice. July 2014. 11(4); 455-466. 10.2217/CPR.14.36
ii Whitehurst L, Pietropaolo A, Geraghty R, Kyriakides R, Somani BK. Factors affecting operative time during ureteroscopy and stone treatment and its effect on outcomes: retrospective results over 6.5 years. Ther Adv Urol. 2020 Jun 23;12:1756287220934403. doi: 10.1177/1756287220934403. PMID: 32636935; PMCID: PMC7313327.
iii HCF. Results Vs Risks of the procedure. https://www.hcf.com.au/preparing-for-hospital/cystoscopy/results-vs-risks-of-the-procedure [Accessed July 2023]
iv Gobbi D, Midrio P, Gamba P. Instrumentation for minimally invasive surgery in pediatric urology. Transl Pediatr. 2016 Oct;5(4):186-204. doi: 10.21037/tp.2016.10.07. PMID: 27867840; PMCID: PMC5107385.