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Urology Instrumentation: A Comprehensive Guide
Sujata K Patwardhan, Ravindra B Sabnis, Arvind P Ganpule
CHAPTER 1:
The Cystoscope and Accessories
INTRODUCTION AND BRIEF HISTORY
THE CYSTOSCOPE SHEATH
Bridges (Figure 6)
Types of Bridges (Classification)
Parts of Bridge
OBTURATORS (Figure 7)
Specifications of Obturators (Figure 7)
SPECIAL TYPES OF CYSTOURETHROSCOPES AND ITS USES
THE TELESCOPES
The Rod-lens System (Figure 9)
Difference between Conventional and Hopkins Rod-lens System1 (Table 3)
Advantages of Hopkins II Lens
Parts of Telescope
Flexible Cystourethroscope (Figure 12)
Types
CHAPTER 2:
Visual Internal Urethrotomy, Otis Urethrotome and Meatotomy Instruments
SACHSE'S OPTICAL URETHROTOMY (Figure 1)
Blades (Figure 2)
Inlet Channel
Accessories for a Sachse's Urethrotomy Sheath
Otis Maurmyers Urethrotome1 (Figure 4)
CHAPTER 3:
TURP Instruments
INTRODUCTION AND HISTORY OF TURP INSTRUMENTS
Resectoscope Sheath (Monopolar)
Parts of Resectoscope
Different ways of Classifying Resectoscopes
Conventional Irrigation
Continuous Irrigation (Figure 2)
What is a Rotating Resectoscope?
Parts of Resectoscope Sheath
External End of the Resectoscope (Figure 3)
Obturator (Figure 4)
Working Element
Loop Control Mechanism
What are the Advantages and Disadvantages of Active and Passive Working Element?
Advantages of Passive Element
Disadvantage of Passive Element
Cutting Loops
Classification of Loops
The Broken Loop (Figures 9A to C)
Uses of Thin Loop
Uses of Thick Loop
Types of Loops (Figure 10)
Problems in Loop Angles
High Frequency Cable
Irrigating Fluids in TURP
Salient Features related to Absorption
TURP SYNDROME
Definition
ACCESSORIES TO EVACUATE PROSTATE CHIPS
Ellik's Evacuator
CHAPTER 4:
Bipolar TURP
IRRIGATION IN BIPOLAR TURP
ADVANTAGES OF BIPOLAR TURP
LIMITATIONS OF BIPOLAR TECHNOLOGY
Types
Olympus TURis System
CHAPTER 5:
Cystolithotrity Instruments
HISTORY AND BRIEF INTRODUCTION
Nomenclature of Various Procedures
Stone Crushing Forceps (Figure 1)
Hendrickson's Classical Lithotrite (Figure 2)
Maurmyers Stone Punch (Figure 3)
CHAPTER 6:
PCNL Instruments
INSTRUMENTS
Access Needles (Figure 1)
Types of Needles (Figure 2)
PCNL Tract Dilators
Tract Dilators
Amplatz Renal Dilator Set (Figure 6)
Metallic Serial Telescopic Dilators (Figures 7A and B)
Balloon Dilatators (Figure 8)4
Nephroscopes
Types of Nephroscopes (Figure 9)
Classification
Miniperc
Accessories of Miniperc (Storz and Wolf)11 Figures 16A and B
Microperc12
ULTRA MINI PCNL
MIP (Minimally Invasive Percutaneous Nephrolithotomy) XS/S
CHAPTER 7:
Semirigid Ureteroscopy
INTRODUCTION
EVOLUTION OF URETEROSCOPES
CLASSIFICATION
Parts (Figure 1)
Olympus Ureteroscopes
Accessories
Instruments used in Retrograde Endopyelotomy
Ureteroresectoscope
Acucise Endopyelotomy (Figure 4)
CHAPTER 8:
Flexible Ureteroscope
TYPES OF FLEXIBLE URETEROSCOPES
Basic Design of a Flexible Fiberoptic Ureteroscope
Optical System
Parts of a Conventional Fiberoptic Flexible Ureteroscope
Why Dual Deflection has Disappeared?
What do you mean by Active and Passive Deflection?
What is Leakage Tester?
Comparison of the Currently Available Flexible Ureteroscopes
Evolution of Flexible Ureteroscopes
Parts of Digital Flexible Ureteroscopes
How does a Digital Flexible Ureteroscope Differ from a Fiberoptic Ureteroscope?
What is ‘Chip on the Tip’ Principle?
Advantages of Digital Flexible Ureteroscope
Disadvantages of Digital Flexible Ureteroscope
Accessories (See Chapter on Accessories)
CHAPTER 9:
Laparoscopy and Robotics: Instruments
LAPAROSCOPIC INSTRUMENTS
Introduction and Brief History
The Armamentarium
Access Devices
Insufflation Devices
Types of Trocars (Figure 3)
Universal Reducer
Reusable Trocars
Instruments Used for the Retroperitoneal Approach
Retracting and Dissecting Instruments
Types of Ratchet for Retracting Instruments
Fan Retractor
Needle Holders (Figure 9)
Parts of the Needle Driver
Laparoscopic Scissors (Figures 10A and B)
Parts of the Scissors
Clip Applicators and Staplers
Hem-o-lok Clip Applicators (Teleflex Medical Inc)
Hem-o-lok Clip Applicator (Figure 12)
How to Load the Clips?
Hem-o-lok™ Clip: Rules for Application (Figure 13)
Types of Interlocking Clips (Figure 14)
Laparoscopic Staplers6
Miscellaneous Instruments
Angle of View (Figure 16)
Special Laparoscopes
ROBOTICS SURGERY IN UROLOGY
Equipments and Supplies
Robotic Instrumentation (Figure 17)
Instrument Housing (E)
CHAPTER 10:
Energy Sources in Open, Laparoscopic and Robotic Surgery
INTRODUCTION
DEFINITIONS1
CLASSIFICATION
Electrosurgical Generator
Monopolar Generator1
ELECTROSURGICAL TISSUE EFFECTS (Figure 4)
Electrosurgical Cutting
Fulguration
Desiccation
Bipolar1
ADVANCE BIPOLAR SYSTEMS
Ethicon Endosurgery Generator
Ultrasonic Generators (Figure 9)
Integrated Ultrasound and Advanced Bipolar Generators
Comparison of Various Energy Sources
Argon Beam Coagulator1
Radiofrequency Ablation
Microwave Ablation
Cryotherapy
SAFETY CONSIDERATION1
CHAPTER 11:
Accessories
URETERIC CATHETER
Material
Types of Ureteric Catheter
Guidewires
Types
Double J Stent (Figure 5A)
Types of Stents
Steps of Memocath Deployment
Miscellaneous Stents
Tubes and Urethral Catheters
Types of Urethral Catheters
Description of Individual Catheters
Red Rubber Catheter (Robinson Catheter)
Nelaton Catheter
Foley Catheters
Types Based on Use
Different Types of end Holes and Catheter Tips
Siliconized Latex Foley Catheters
Three-way Hemostatic Catheters
Various Size Parameters and Color Coding of Catheters (Table 1 and Figure 6)
3-Way Foley Hematuria Catheters26 (Figure 7)
Tiemann Catheter (Figure 8)
Nephrostomy Tubes (Figures 9A and B)
Baskets and Retropulsion Devices (Figure 11)
Peculiarities
Two Types
Retropulsion Devices
Urethral Balloon Dilators
URETERIC DILATOR
PASSIVE DILATORS: DJ STENTS
Active Dilators
Access Sheath
Parts
Available Sizes
Types
Special Types
Comparison of Companies
Properties of a Ideal Access Sheath
PCNL Accessories (Figures 14A and B)
CHAPTER 12:
Sterilization
DEFINITIONS
Approach to Disinfection and Sterilization
Spauldings Classification2
Different Methods of Sterilization1,5
Facts and Myths Regarding Steam Sterilization
Myths and Common Procedural Mistakes
Hydrogen Peroxide Gas Plasma Sterilization
Myths/Facts and Common Procedural Mistakes in Plasma Sterilization
Ethylene Oxide sterilization (ETO)
Facts/Myths for ETO Sterilization
Chemical Agents Used as Disinfectants/Sterilants
Glutaraldehyde
Glutaraldehyde (Cidex) Sterilization
Product Description
MYTHS
Formaldehyde
Orthophthalaldehyde (OPA)
Per Acetic Acid
Uses
Iodophors
Hydrogen Peroxide
STEPS OF STERILIZATION AND PROCESSING OF SURGICAL INSTRUMENTS
Sterilization of Individual Instruments
TURP Instruments—Spaulding-high Level Disinfection or Sterilization
Sterilization of Ureteroscopes-semicritical item- Recommended High Level Disinfection
Sterilization of Accessories
Salient Features for Sterilization of Cystoscopes and Telescopes
Tips and Tricks in Sterilizing
CHAPTER 13:
Open Urology Instruments
OPEN SURGERY RETRACTORS
Bookwalter Retractor (Figure 1)
Denis Brown Abdominal Retractor (Figure 2)
Millin's Self-retaining Bladder Retractor with a Provision for Attachment of Third Blade (Figure 3)
Ring Retractor (Figures 4A and B)
Gilvernet Hilar Retractor (Figure 5A)
VASCULAR INSTRUMENTS
Straight
Curved
USES OF VASCULAR INSTRUMENTS
STONE HOLDING FORCEPS
USE
INSTRUMENTS USED IN URETHRAL SURGERY
Chisel and Gouge (Figure 13B)
Dilators
Uses of Metallic Bougie
Haygrove Sound (Figures 15A and B)
CHAPTER 14:
Pediatric Urology
DEFLUX
Indications
Contraindications
PEDIATRIC ENDOUROLOGY INSTRUMENTS
Pediatric Operating Cystoscope—Urethroscope
8/9.5 Fr with Angled Eyepiece (Figures 2A and B)
9.5 Fr Scope with forward-oblique Telescope 30º (Figure 3)
Instruments for use with Pediatric Operating Cystoscope-Urethroscope 9.5 Fr
Pediatric Cystoscope-urethro-fiberscope (Figures 6 to 8)
Positive Deflection Mechanism
Contrapositive Deflection Mechanism
Diagnostic and Therapeutic Indications for the Ureteral and Renal Tract
Diagnosis
Therapy
Neonatal Cystoscope-Urethroscope 7/9 Fr (Figure 10)
Pediatric Operating Cystoscope-urethroscope with Straight Forward Telescope 00 (Figure 11)
For Use with Deflux Needles
Pediatric Resectoscopes
Special features
Pediatric Optical Urethrotome
Special features
Urethrotome Sheath with LUER Lock, 8 Fr, with Obturator (Figure 16)
Pediatric Urethrotome (OTIS-KEITZER) (Figure 17)
Pediatric Percutaneous Nephroscope (Figures 18A and B)
Pediatric Ureterorenoscopes (Figure 19)
Special features
INDEX
TOC
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