We have recently started to use the DUR-D ureteroscope for ureteroscopy, and it has provided us a detailed view of the ureters and kidneys like we have never seen before. I had heard, however, that the DUR-D does not do well in a bloody field, and today we had our first case using the DUR-D in a very bloody renal pelvis full of transitional cell carcinoma.
Upon entering the kidney, there was a large amount of blood clot. I deployed a 12/14 access sheath and three large pieces were expelled. I then inserted the DUR-D and, as you can see from the below video, the view was indeed somewhat diminished. I was, however, able to get a really decent view of the tumor in the upper pole, and I was also able to evaluate the interpolar and lower pole areas. So while further investigation is warranted, it seems that distal sensor ureteroscopes do perform adequately in a bloody environment.
4 responses so far ↓
1 jackb // Mar 22, 2008 at 10:56 am
is the image always that narrow, as it appears in the video?
2 Jaime Landman // Mar 22, 2008 at 11:03 am
No, actually this is some artifact of the way that I edited up the video or from the posting on this website. I will try and fix it as it does look awkward . In think that the image should be a perfect square.
3 Sanjib Mohanty // Jun 15, 2008 at 2:32 pm
The images are very good and pretty much acceptable to me- Is this the Invisio line of Ureteroscope ?
Thanks
4 Jaime Landman // Jun 16, 2008 at 11:51 am
Yes, the ureteroscope used to make this video is the DUR-D. SInce the time of this video we have actually received a software update that has even improved our vision further. Because of this ureteroscope, I am actually re-defining what I see in the kidney.
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