scholarly journals Stone clearance times with mini-percutaneous nephrolithotomy: Comparison of a 1.5 mm ballistic/ultrasonic mini-probe vs. laser

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Brennan Timm ◽  
Matthew Farag ◽  
Niall F. Davis ◽  
David Webb ◽  
David Angus ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Alternative Energy ◽  
Final Analysis ◽  
Time Interval ◽  
Clearance Time ◽  
Ho:Yag Laser ◽  
Stone Clearance ◽  
Alternative Energy Sources ◽  
The Mean ◽  
Better Than

Introduction: A limitation of mini-percutaneous nephrolithotomy (mPCNL) is the narrow working channel of mini-nephroscopes, typically restricting instrumentation to 5 F or smaller. We evaluated the efficacy of the 1.5 mm Swiss Lithoclast® Trilogy (Trilogy) rigid probe and compared the results to consecutive cases performed with a 30 W Holmium:YAG (Ho:YAG) laser. Methods: A retrospective review of 30 consecutive mPCNL cases using the Trilogy and 30 W Holmium laser was performed. A 12-French (F) MIPS nephroscope with a 16.5 F access sheath and 6.7 F working channel was used for all mPCNL cases. The Trilogy was used with a disposable 1.5 mm x 440 mm probe with dual ultrasonic and ballistic energy. The Ho:YAG laser was used with a 550 micron fibre and a maximum of 30 W. Stone clearance time (SCT) was defined by the total time interval between activation of the lithotripter until insertion of the nephrostomy tube and measured in mm2/minutes. SCT included time for fragment retrieval, equipment adjustments, and rigid and flexible nephroscopy during and after lithotripsy. Results: Eleven cases using a 1.5 mm Trilogy probe and 16 cases using a Ho:YAG laser met final inclusion criteria. Three cases using the Trilogy were excluded from final analysis due to conversion to alternative energy sources — two of those were upsized to standard PCNL and one was converted to laser. Mean stone diameter and density in the final Trilogy cohort was 26.7 mm and 1193 Hounsfield units (HU). Mean diameter and density in the laser cohort was 25.2 mm and 1049 HU. The mean stone area clearance time for Trilogy was 4.7±1.8 mm2/minute vs. 3.4±0.7 mm2/minute with Ho:YAG laser (p=0.21). For hard stones, defined as density >1000 HU, the Trilogy averaged 3.7±1.6 mm2/minutes, while the laser averaged 3.1±1.3 mm2/minutes (p=0.786). For soft stones, defined as <1000 HU, the Trilogy averaged 8.9±1.0 mm2/minutes compared to the Ho:YAG, which averaged 3.6±1.8mm2/minutes (p=0.019). No device0related complications occurred in either cohort. Conclusions: The 1.5 mm mPCNL Trilogy probe was comparable to 30 W Ho:YAG laser for clearing hard stones. The Trilogy performed better than laser on soft stones with a HU density <1000 HU.

scholarly journals PEMANFAATAN BIOGAS TERMURNIKAN BERBASIS METODE KALSINASI PADA KENDARAAN BERMOTOR

2013 ◽  
Vol 3 (1) ◽  
Author(s):  
Rudy S ◽  
IGB Dipa Maha Putra ◽  
Arif Mulyanto
Keyword(s):  
Motor Performance ◽  
Alternative Energy ◽  
Motor Fuel ◽  
Performance Testing ◽  
Motor Gasoline ◽  
Alternative Energy Sources ◽  
Biogas Purification ◽  
Carbon Dioxide Co2 ◽  
Better Than

 Biogas is one of the alternative energy sources that are environmentally friendly, inexpensive, easily available, renewable, and can be used as a substitute for gasoline for motor gasoline. For the use of biogas in the motor gasoline is necessary to improve the quality of biogas that is more optimal use of biogas when used as fuel.This study aims to determine the reduction of carbon dioxide (CO2) during the purification of biogas by using absorber Ca (OH)2 to the elevated levels of CH4 in biogas and its effect when testing the performance of the motor fuel, which indicate the performance of the motor fuel is the torque, power and effective specific Fuel Consumption effective. In this study, the biogas will be purified by varying the flow rate is var I (5 liters / min), var II (10 ltr / min) and var III (15 ltr / min), and biogas purification degan best quality results will be compared with biogas before purification by way of testing the motor performance in round 1500 rpm, 2500 rpm,3500rpm and 4500 rpm.The result showed that the purification of biogas menggunan Ca (OH)2 at a rate var II (10 ltr / min) produced the best biogas CH4 content of 91.0%, better than the variations I and III variations, and the results of performance testing of the motor fuel showed improvement menghasillkan better quality. Judging from rotation 4500 rpm for prior purification 5.9399 Nm torque, power and SFCe effective 2797.7079 W 0.000164 (kg / jam.W), whereas after purification 6.5821 Nm torque, effective power 3100.1628 W and SFCe 0.000113 (kg / jam.W)

scholarly journals Prediction of Surgical Outcome after Percutaneous Nephrolithotomy through Guy’s Score and Nephrolithometric Nomogram

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
K A Teama ◽  
M I Shabayek ◽  
T I S Aly
Keyword(s):  
Quality Of Life ◽  
Percutaneous Nephrolithotomy ◽  
Scoring Systems ◽  
Renal Stones ◽  
University Hospitals ◽  
Stone Clearance ◽  
Stone Free Rate ◽  
The Mean ◽  
Free Rate

Abstract Background Urolithiasis has a well documented common occurrence in the general population. Percutaneous nephrolithotomy (PCNL), has prevailed over other more morbid procedures, like open surgeries in the management of such stones PNL in complex renal stones is a challenging procedure because it requires considerable experience in gaining percutaneous tracts, performing delicate and judicious intrarenal manipulations, mastering all techniques of intracorporeal stone disintegration, and weighing the benefits of complete stone clearance against the risks of complications. Aim of the Work GSS and Nephrolithometric Nomogram. Scoring system in predicting PCNL outcomes. The ability of the GSS and STONE score to correlate with the post-operative change in the quality of life. Patients and Methods In a non-randomized prospective study we evaluated the two scoring systems Guy’s and S.T.O.N.E. nephrolithometry scoring systems in predicting the success rate of PCNl and the quality of life. This study included 100 patients with renal stones who were scheduled for PCNL at El Demerdash University Hospitals and Nasser institute hospital in the period from April 2017 to October 2018. Results Our study included 100 patients (34 were female, 66 were male) with a mean age of 46.16 (range from 28 to 68). The mean GUY score was 1.57± 0.73 and the mean STONE score was 5.76± 1.19.the overall stone free rate was 89% with a complication rate of 18% with a mean stone burden &lt;400 mm.GUY and STONE score were able to predict SFR and complications after PCNL. Conclusion Both GSS and S.T.O.N.E Nephrolithometry Score can be used to stratify the complexity of renal stone before PCNL to predict the stone clearance and complication. Both can be valuable tools for providing uniformity for comparison of outcome, proper planning of the surgery and preoperative counseling of the patient.

scholarly journals Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

2018 ◽  
Vol 16 (3) ◽  
pp. 274-278
Author(s):  
Udaya Man Singh Dongol ◽  
Sandeep Bohora
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Operating Time ◽  
Lower Pole ◽  
Stone Size ◽  
Stone Clearance ◽  
Minimally Invasive Surgical ◽  
The Mean ◽  
Complications Rate

Background:  Urolithiasis is a worldwide problem  due to its high prevalence and  recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and  efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones.Methods: Seventy  patients who presented in between June 2013 and September 2017 with  lower pole calyceal stones and lower calyceal stones with pelvic extension  were included in the study. The  operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.

scholarly journals Comparison of Standard Percutaneous Nephrolithotomy with Mini-Percutaneous Nephrolithotomy for Removal of Renal Stones in Adults

2021 ◽  
Vol 5 (2) ◽  
pp. 20-25
Author(s):  
Asif Alam Khan ◽  
Inam Malkani ◽  
Junaid Jameel Khattak ◽  
Hassan Mumtaz ◽  
Mubashir Mazhar ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Operative Time ◽  
Treatment Time ◽  
Renal Stones ◽  
Hemoglobin Level ◽  
Stone Clearance ◽  
Group A ◽  
The Mean ◽  
Group B

Renal stones are the third most common problem affecting about 10% of global population. The management of nephrolithiasis has undergone a complete transformation since the 1980s. Percutaneous nephrolithotomy (PCNL) has established itself an effective and safe technique that delivers high stone-free rate as well as overall shorter treatment time. We aim to compare the outcome of mini-PCNL with standard-PCNL in patients presenting with renal stones. In all, 90 patients fulfilled the selection criteria and randomized into two groups. Group A underwent mini-PCNL whereas Group B underwent standard-PCNL. Pre-operative hemoglobin level was recorded. Duration of procedure as well as drop in hemoglobin level was also recorded. A kidney, ureter, and bladder (KUB) X-ray was performed to confirm the presence of of stone and stone-free status. The mean age of patients in mini-PCNL group was 43.11 years and in standard-PCNL group, it was 36.91 years. The mean stone size in patients of mini-PCNL group was 29.53 mm and 31.58 mm in standard-PCNL group. The mean duration of renal stone in mini-PCNL group was 1.91 years and that in standard-PCNL group 1.80 years. The mean operative time in mini-PCNL group was 59.56 min and 61.22 min in standard-PCNL group. The mean fall in hemoglobin in mini-PCNL group was 0.38 g/dL and that in standard-PCNL group 0.51 g/dL. In mini-PCNL group, stone clearance was observed in 42 (93.3%) patients, while in standard-PCNL group, it was observed in 45 (100%) patients. This difference was insignificant (P > 0.05). Mini-PCNL and standard-PCNL have no significant differences in terms of outcome, operative time, and stone clearance, although fall in hemoglobin level was less in mini-PCNL group, which showed less blood loss in this group, thereby making it a more appropriate method for renal stone removal.  

scholarly journals Outcome of Percutaneous Nephrolithotomy in the Management of Lower Pole Stones

2018 ◽  
Vol 16 (3) ◽  
pp. 274-278
Author(s):  
Udaya Man Singh Dongol ◽  
Sandeep Bohora
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Clearance Rate ◽  
Operating Time ◽  
Lower Pole ◽  
Stone Size ◽  
Stone Clearance ◽  
Minimally Invasive Surgical ◽  
The Mean ◽  
Complications Rate

Background: Urolithiasis is a worldwide problem  due to its high prevalence and  recurrence. Percutaneous nephrolithotomy is a minimally invasive surgical option for the treatment of large renal stone burden greater than 20mm, staghorn calculi and lower pole calyceal stone greater than 10 mm. The objective of this study was to evaluate the safety and  efficacy of percutaneous nephrolithotomy in the management of lower pole calyceal stones. Methods: Seventy  patients who presented in between June 2013 and September 2017 with  lower pole calyceal stones and lower calyceal stones with pelvic extension  were included in the study. The operating time, the hospital stay, complications rate, stone clearance rate were all noted. Patients were followed up in three and six weeks with X-ray KUB and ultrasonography of abdomen.Results: Seventy adult patients with lower pole calyceal stones underwent standard percutaneous nephrolithotomy. The mean age was 32 years (18-71 yrs). The mean stone size was 17.6 mm (15 –28 mm). The mean operating time was 62 minutes (48-124 mins) and hospital stay was 4.1 days(4-8 days). The stone clearance rate was 92.6% for stone <20mm and 90.7% stone size >20 mm. The complications noted were fever (8.5%), transient haematuria (20%), urine leak (5.7%), obstruction by residual fragments (5.7%) and one pseudoaneurysm(1.42%). Seven patients (10%) needed blood transfusion.Conclusions: Percutaneous nephrolithotomy is a safe, feasible and highly effective method for the treatment of lower pole calyceal stones.Keywords: Lower calyx; lower pole stones; percutaneous nephrolithotomy; stone free rate.

scholarly journals Safety and efficacy of percutaneous nephrolithotomy for the treatment of paediatric urolithiasis

2012 ◽  
Vol 94 (8) ◽  
pp. 588-592 ◽  
Author(s):  
R Veeratterapillay ◽  
MBK Shaw ◽  
R Williams ◽  
P Haslam ◽  
A Lall ◽  
...  
Keyword(s):  
Percutaneous Nephrolithotomy ◽  
Renal Calculi ◽  
Clearance Rates ◽  
Stone Clearance ◽  
Extracorporeal Shock Wave ◽  
Stone Free Rate ◽  
Surgeon Experience ◽  
The Mean ◽  
Free Rate

INTRODUCTION Paediatric percutaneous nephrolithotomy (PCNL) has revolutionised the treatment of paediatric nephrolithiasis. Paediatric PCNL has been performed using both adult and paediatric instruments. Stone clearance rates and complications vary according to the technique used and surgeon experience. We present our experience with PCNL using adult instruments and a 28Fr access tract for large renal calculi in children under 18 years. METHODS All patients undergoing PCNL at our institution between 2000 and 2009 were reviewed. Demographics, surgical details and post-operative follow-up information were obtained to identify stone clearance rates and complications. RESULTS PCNL was performed in 32 renal units in 31 patients (mean age: 10.8 years). The mean stone diameter was 19mm (range: 5–40mm). Twenty-six cases required single puncture and six required multiple tracts. Overall, 11 staghorn stones, 10 multiple calyceal stones and 11 single stones were treated. Twenty-seven patients (84%) were completely stone free following initial PCNL. Two cases had extracorporeal shock wave lithotripsy for residual fragments, giving an overall stone free rate of 91% following treatment. There was no significant bleeding or sepsis encountered either during the operation or in the post-operative setting. No patient required or received a blood transfusion. CONCLUSIONS Paediatric PCNL can be performed safely with minimal morbidity using adult instruments for large stone burden, enabling rapid and complete stone clearance.

Development of the algorithm for the selection of a wind generator-based autonomous power supply system

2019 ◽  
Vol 2 (1) ◽  
pp. 8-16 ◽  
Author(s):  
P. A. Khlyupin ◽  
G. N. Ispulaeva
Keyword(s):  
Wind Turbines ◽  
Power Supply ◽  
Alternative Energy ◽  
Power Supply System ◽  
Supply System ◽  
Power Generators ◽  
Energy Devices ◽  
Wind Generator ◽  
Alternative Energy Sources ◽  
Selection Of

Introduction: The co-authors provide an overview of the main types of wind turbines and power generators installed into wind energy devices, as well as advanced technological solutions. The co-authors have identified the principal strengths and weaknesses of existing wind power generators, if applied as alternative energy sources. The co-authors have proven the need to develop an algorithm for the selection of a wind generator-based autonomous power supply system in the course of designing windmill farms in Russia. Methods: The co-authors have analyzed several types of wind turbines and power generators. Results and discussions: The algorithm for the selection of a wind generator-based autonomous power supply system is presented as a first approximation. Conclusion: The emerging algorithm enables designers to develop an effective wind generator-based autonomous power supply system.

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