Sealable Pouch for Kidney Stone Fragmentation Containment
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Solution Overview
Problem
During percutaneous nephrolithotomy (PCNL) procedures, large kidney stones often require fragmentation, leading to small fragments migrating and being missed, increasing operative time and the need for additional procedures to remove residual fragments.
Innovation Solution
A sealable polyethylene pouch, referred to as PercSac, is deployed over a rigid nephroscope to capture and fragment kidney stones, preventing fragment migration and allowing for complete removal.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If large kidney stones are fragmented during PCNL procedure, then stones can be removed, but small fragments migrate and are missed, increasing operative time and requiring additional procedures
Solution Approach 1:
A flexible pouch is introduced as an intermediary device between the fragmentation tools and the kidney stones. The pouch captures and contains stone fragments during lithotripsy, preventing their migration into the renal collecting system. This intermediary structure allows complete fragment containment while enabling efficient stone breakdown and removal.
Solution Approach 2:
The invention employs a flexible pouch made of thin, compliant material that can be inserted through a rigid nephroscope. The flexible shell conforms to the irregular shapes of kidney stones and captures fragments of various sizes. The thin-film structure allows passage through narrow access paths while providing effective fragment containment.
2Reliability
If flexible endoscope is inserted to search for residual fragments, then complete stone removal can be achieved, but operative time and cost increase
Solution Approach 1:
The flexible pouch is deployed before stone fragmentation begins, establishing a containment system in advance. This preliminary action ensures that all fragments generated during lithotripsy are captured from the start, eliminating the need for subsequent searches with flexible endoscopes to locate residual fragments.
Solution Approach 2:
The pouch acts as an intermediary containment structure that intercepts fragments before they can migrate into difficult-to-access areas of the kidney. By capturing fragments at the source, the pouch eliminates the need for time-consuming visual searches with flexible endoscopes.
3Measurement precision
If rigid nephroscope is used for stone fragmentation, then direct vision is achieved, but small fragments can still migrate and be missed
Solution Approach 1:
The flexible pouch creates a sealed containment environment within the rigid nephroscope's field of view. The thin-film structure allows complete visual inspection of the fragmentation process while preventing fragment escape, combining the advantages of rigid scope stability with flexible containment adaptability.
Solution Approach 2:
The pouch serves as an intermediary barrier between the rigid nephroscope and the kidney stones. It maintains the visual advantages of rigid scope while adding fragment containment capability, preventing the limitation of rigid scopes (inability to contain fragments) from compromising overall reliability.
Data Source
AI summary
Devices and methods for removal of calculus (including for example, kidney stones) are disclosed. In an embodiment, a device for removal of kidney stones includes a substantially sealable pouch that can be inserted into the kidney for capturing a kidney stone. The pouch is also designed to permit fragmentation of the kidney stone inside the pouch, while preventing kidney stone fragments from escaping from the pouch. As a result, the likelihood of dispersing stone fragments during fragmentation of a large stone is greatly lessened.