title: A novel device to prevent stone fragment migration during percutaneous lithotripsy.
abstract: OBJECTIVE
  We developed a novel device to capture stones in vivo in an enclosed bag (PercSac) to prevent dispersion of stone fragments during percutaneous nephrolithotomy (PCNL) or cystolitholapaxy. We report on our initial feasibility trials of the PercSac device.
  
  
  METHODS
  PercSac consists of a specially designed polyethylene bag that is fitted over the shaft of a rigid nephroscope. The bag is used to first entrap the target stone, then tighten around it to allow fragmentation within the bag. Matched pairs of 10 canine bladder stones (2.5 cm maximum diameter) were fragmented in a human bladder model using the CyberWand (Olympus America, Inc.), and the procedure was assessed for markers of efficiency and effectiveness.
  
  
  RESULTS
  Median time to entrap the stone within the PercSac was 67 seconds (range 51-185 sec). Median time for stone fragmentation was significantly shorter with the PercSac than without (182.0 sec [range 108-221] vs 296.5 sec [range 226-398], P=0.004). Overall, however, there was no significant difference in the total time to entrap and fragment the stones between the two groups. A stone-free state was not achieved for any trial without the PercSac, while 9 of 10 trials with the PercSac resulted in a stone-free state.
  
  
  CONCLUSIONS
  Use of the PercSac in conjunction with stone fragmentation has the potential to reduce the occurrence of residual fragments after PCNL or cystolitholapaxy. Further in vitro testing in a kidney model is planned.
authors.affiliation: 1 Department of Urology, University of Texas Southwestern Medical Center , Dallas, Texas.
authors.forename: Justin I
authors.initials: JI
authors.lastname: Friedlander
authors.forename: Jodi A
authors.initials: JA
authors.lastname: Antonelli
authors.forename: Heather
authors.initials: H
authors.lastname: Beardsley
authors.forename: Stephen
authors.initials: S
authors.lastname: Faddegon
authors.forename: Monica S C
authors.initials: MS
authors.lastname: Morgan
authors.forename: Jeffrey C
authors.initials: JC
authors.lastname: Gahan
authors.forename: Margaret S
authors.initials: MS
authors.lastname: Pearle
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Cadeddu
mesh_terms: D000818:Animals; D004285:Dogs; D019723:Endoscopes; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy / Q000379:methods*; D008953:Models, Anatomic; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D061646:Operative Time; D001743:Urinary Bladder / Q000601:surgery*; D001744:Urinary Bladder Calculi / Q000601:surgery*