Case-Specific Irrigation Pressure Control for Kidney Distention
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Solution Overview
Problem
Improper management of irrigation and aspiration during medical procedures can adversely affect patient health and procedure efficacy, particularly in nephroscopic procedures where over- or under-pressurization of the kidney can cause damage or reduce visibility.
Innovation Solution
Implementing case-specific fluid pressure limits based on parameters such as sheath angle, aspiration flow, active suction, sheath height, and patient position to maintain optimal kidney distention without causing harm, using robotic systems and fluid management systems to dynamically adjust pressure limits in real-time.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Illumination intensity
If high irrigation pressure is applied to distend the kidney for visibility, then procedural visibility is improved, but kidney damage risk increases
Solution Approach 1:
The system dynamically adjusts irrigation pressure in real-time based on monitored kidney distention levels and procedural conditions. The pressure limit is not fixed but adapts continuously to maintain optimal visibility while preventing damage, transitioning from static to dynamic pressure control.
Solution Approach 2:
The system implements closed-loop feedback by monitoring kidney distention, irrigation flow, and pressure levels, then using this information to automatically adjust irrigation pressure. Sensors detect kidney state and feed this data back to the control system, which modulates pressure to maintain safety margins while ensuring adequate visibility.
2Device complexity
If fixed irrigation pressure limits are used, then system simplicity is maintained, but case-specific optimization is lost
Solution Approach 1:
The system changes the parameter of irrigation pressure limit based on case-specific inputs such as patient anatomy, procedural stage, and real-time kidney response. Instead of a single fixed pressure value, the system computes and applies customized pressure limits tailored to each specific surgical case and its evolving conditions.
Solution Approach 2:
The system performs preliminary assessment of case-specific parameters before initiating irrigation, such as evaluating patient anatomy, sheath configuration, and procedural requirements. This preliminary action allows the system to pre-calculate appropriate pressure limits before the procedure begins or before critical phases are reached.
3Reliability
If real-time pressure adjustment is implemented, then kidney safety is improved, but system complexity increases
Solution Approach 1:
The system performs self-monitoring and self-adjustment of irrigation pressure without requiring constant manual intervention. The automated control system continuously monitors kidney distention and irrigation parameters, then autonomously modulates pressure to maintain safety, reducing the need for complex manual control mechanisms while improving reliability.
Solution Approach 2:
The system replaces manual mechanical pressure control with automated electronic control based on sensor feedback. Instead of relying on manual valve adjustments and mechanical pressure regulators, the system uses electronic sensors, processors, and actuators to achieve precise pressure modulation, trading mechanical simplicity for automated safety.
Data Source
AI summary
A method of managing fluid conditions in a patient involves advancing at least one medical instrument into a target organ of a patient, the at least one medical instrument comprising an irrigation channel and an aspiration channel, coupling the at least one medical instrument to an irrigation fluid source, providing irrigation from the irrigation fluid source into the target organ through the irrigation channel of the at least one medical instrument, determining an irrigation pressure limit based at least in part on one or more case-specific parameters, providing irrigation into the target organ through the irrigation channel, and limiting the irrigation based at least in part on the determined irrigation pressure limit.