The cold knife: a new laparoscopic instrument for ureteropelvic junction incision.
OBJECTIVE
The use of laparoscopic scissors or blades in laparoscopic nondismembered pyeloplasty is quite common; however, the incision made using these tools may cause difficulties for the surgeon. We developed an efficient, safe, reusable, and inexpensive instrument to incise the pelvis and ureter during laparoscopic pyeloplasty. The aim of the present study was to evaluate the new laparoscopic instrument designed for pelvic and ureteric incisions.


METHODS
The cold knife consists of an internal urethrotome that is transformed into an endoscopic instrument that can be inserted easily through a 5-mm-diameter trocar. It has a manual retraction system that enables a stand-by position for added protection when no incisions are being made. The new tool was trialed in laparoscopic Y-V pyeloplasty. Data regarding perioperative parameters and outcomes were collected and analyzed.


RESULTS
Eight patients participated in the present study. All patients underwent Y-V pyeloplasty using a three-port retroperitoneal access. Mean operative time was 166.2 minutes (range: 100-300). There were no complications during the procedures.


CONCLUSIONS
Laparoscopic cold knife for laparoscopic pyeloplasty is a simple, safe, reusable, and inexpensive instrument with a low maintenance cost.
Guven
Selcuk
S
Department of Urology, Selcuk University Meram Medical School , Konya, Turkey. selcukguven@selcuk.edu.tr
Kilinc
Mehmet
M
Tunc
Lutfi
L
Yuksel
Dilek
D
Ozgok
Aysegul
A
Ozgok
Yasar
Y
D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D014513:Ureter / Q000601:surgery*; D014517:Ureteral Obstruction / Q000601:surgery*; D055815:Young Adult