Ureteroscopy: The Latest Advancements and Techniques with Dr. Amy E. Krambeck, MD скачать в хорошем качестве

Ureteroscopy: The Latest Advancements and Techniques with Dr. Amy E. Krambeck, MD

Amy E. Krambeck, MD, Professor of Urology at Northwestern University Feinberg School of Medicine, Chicago, Illinois, explores advancements in ureteroscopy. In this 21-minute presentation, Dr. Krambeck highlights significant improvements in ureteroscope design, ancillary devices, and laser technologies. Dr. Krambeck shares that digital ureteroscopes enhance visibility, maneuverability, and durability. Miniaturization has improved with smaller flexible scopes, larger working channels, and disposable options, reducing maintenance costs while maintaining image quality. Fragmentation and retrieval devices have evolved, with smaller fibers and softer nitinol baskets improving safety and efficiency. The role of access sheaths remains crucial, offering multiple passes, enhanced visualization, and improved stone-free rates. Dr. Krambeck emphasizes intrarenal pressure management, illustrating its importance through porcine models. She introduces a novel disposable ureteroscope with integrated pressure monitoring with an access sheath that maintains intrarenal pressures within safe limits. She also introduces emerging suction access sheaths, such as the ClearPetra system. The CVAC system integrates suction directly into the ureteroscope and shows promise in improving stone clearance. Laser technology continues to advance, with holmium and thulium fiber lasers offering distinct benefits. Pulse modulation may improve efficiency, while thulium lasers provide better retropulsion control but generate higher heat. Dr. Krambeck advocates a structured approach to ureteroscopy, emphasizing the importance of miniaturization, controlled irrigation, and careful laser use to enhance procedural outcomes while minimizing complications.