The use of the Acucise technique for ureteropelvic junction obstruction: a trade-off between efficacy and invasiveness?
Open pyeloplasty is traditionally the recommended treatment for ureteropelvic junction obstruction. In the past decades, several less invasive procedures emerged with the advantages of lower morbidity and better patient tolerance. In 1993, an electrosurgical cutting balloon device called the Acucise (Applied Medical Resources Corp., Laguna Hills, CA) was introduced. It was presented as a straightforward, safe procedure that can be performed in a complete retrograde fashion under fluoroscopic guidance. Despite these advantages; however, it is not yet a generally excepted procedure. This is mainly due to the fact that specific patient selection is needed, and success rates are comparable with other already established endoscopic procedures. Considering the large variety of minimally invasive procedures available, treatment of choice must be based on several factors such as success rate, morbidity, cost, and surgeon's experience. Acucise is considered a good alternative for the treatment of ureteropelvic junction obstruction in selected patients. However, the efficacy is significantly lower than the reference standard.
Baard
Joyce
J
Department of Urology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. j.baard@amc.uva.nl
de Reijke
Theodorus M
TM
de la Rosette
Jean J M C H
JJ
D000328:Adult; D002404:Catheterization / Q000295:instrumentation* / Q000379:methods; D002648:Child; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D005471:Fluoroscopy; D005500:Follow-Up Studies; D006801:Humans; D007682:Kidney Pelvis / Q000503:physiopathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D010149:Postoperative Pain / Q000503:physiopathology; D018579:Patient Selection; D018570:Risk Assessment; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods