title: New for Old-Coagulum Lithotomy vs a Novel Bioadhesive for Complete Removal of Stone Fragments in a Comparative Study in an Ex Vivo Porcine Model.
abstract: To evaluate a recently reported new bioadhesive system for the retrieval of small residual fragments (RFs) after intracorporeal lithotripsy, we systematically compared this system with coagulum lithotomy in retrograde intrarenal surgery.
  
  
  
  We extracted 30 human stone fragments (≤1 mm) in an ex vivo porcine kidney model using a flexible ureteroscope for three groups: (1) the novel bioadhesive, (2) autologous blood as a natural adhesive, and (3) (control group) a conventional retrieval basket. Each group consisted of 15 test runs. Outcomes were evaluated regarding the macroscopic stone-free rate (SFR), retrieval time, and number of ureteral passages.
  
  
  
  For groups 1 and 2, a significant advantage in stone clearance, mean retrieval time, and number of retrievals was detected compared to the control group (p = 0.001). The time and number of retrievals were significantly lower in group 1 (10:36 minutes, p = 0.001) than in group 2 (26:12 minutes, p = 0.001), with shorter clotting time and better visibility.
  
  
  
  These data show the general feasibility of intrarenal RF embedding to improve the SFR. Our data furthermore suggest the superiority of the artificial bioadhesive embedding agent over the application of native blood. Further in vivo studies and other research are necessary to confirm the adhesive's effect in patients.
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Dominik Stefan
authors.initials: DS
authors.lastname: Schoeb
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Martin
authors.initials: M
authors.lastname: Schoenthaler
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Daniel
authors.initials: D
authors.lastname: Schlager
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Ralf
authors.initials: R
authors.lastname: Petzold
authors.affiliation: 2 Department of Adhesive Bonding Technology and Surfaces, Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM , Bremen, Germany .
authors.forename: Katharina
authors.initials: K
authors.lastname: Richter
authors.affiliation: 2 Department of Adhesive Bonding Technology and Surfaces, Fraunhofer Institute for Manufacturing Technology and Advanced Materials IFAM , Bremen, Germany .
authors.forename: Ingo
authors.initials: I
authors.lastname: Grunwald
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Ulrich
authors.initials: U
authors.lastname: Wetterauer
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Miernik
authors.affiliation: 1 Department of Urology, Faculty of Medicine, Medical Center-University of Freiburg , Freiburg, Germany .
authors.forename: Simon
authors.initials: S
authors.lastname: Hein
mesh_terms: D000269:Adhesives; D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008096:Lithotripsy; D013552:Swine; D018666:Ureteroscopy / Q000295:instrumentation* / Q000379:methods
chemical_list: D000269:Adhesives
keywords: kidney calculi/therapy; ureteroscopy/instrumentation; ureteroscopy/methods; ureteroscopy/therapy; urolithiasis/therapy