Publications by authors named "Etienne-Xavier Keller"
Assessing flexible ureteroscopy outcomes for lower Pole versus non lower Pole stones using the flexible and navigable suction ureteric access sheath: a prospective multicenter study by EAU Endourology and PEARLS group.
World J Urol
December 2024
Purpose: Use of suction in flexible ureteroscopy is increasing lately. The introduction of flexible and navigable suction access sheath (FANS) has shown improved stone free rate (SFR). However, its efficacy in lower pole stone (LPS) in terms of SFR and complications is yet to be studied.
View Article and Find Full Text PDFA Global Survey to Assess Urologists' Attitudes Towards Suction Technology in Endourology by the European Association of Urology Section of Endourology and Progressive Endourological Association for Research and Leading Solutions.
Urology
December 2024
Objective: To assess urologists' perceptions and current practices of using suction-based techniques and technologies in percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) for kidney stones.
Materials And Methods: A customized web-based 28-item questionnaire was created. All participation was voluntary.
Objective: To evaluate the impact of coiling of the proximal end of the ureteral stent on stent-related symptoms (SRS) in in subgroup of patients undergoing preoperative ureteral stenting preceding flexible retrograde intrarenal surgery (RIRS).
Materials And Methods: We performed a prospective comparative study including patients undergoing stent placement 7-10 days prior to RIRS. Patients were divided into 2 groups; in Group 1 coiling of proximal end of the DJ was present, while in Group 2 coiling was absent.
Article Synopsis
- The review aimed to evaluate the effects of pulse modulation technology on laser lithotripsy and prostate enucleation in endourology, focusing on efficiency, safety, and tissue interaction.
- A systematic search of studies from the last 20 years identified 29 articles that examined these technologies, with preclinical studies showing promise in stone fragmentation but mixed results in clinical settings.
- While pulse modulation can improve operational efficiency and reduce thermal safety risks, its benefits for prostate surgery outcomes remain inconsistent, yielding comparable rates to standard modalities in terms of stone-free status and complications.
Background And Objective: We analysed gender trends for urology trainees and consultants across nine European countries (Spain, UK, Netherlands, Norway, Germany, France, Belgium, Italy, and Switzerland) over a 10-yr period (2012-2022) to gain insight into gender dynamics in urology and determine if there is increasing representation of women in the profession. This information will help in the development of more effective strategies to promote gender equality.
Methods: Data from the past decade were collected, encompassing trainee and consultant records nationally.
Article Synopsis
- The study evaluates the deflection angles of Flexible and Navigable Suction Ureteral Access Sheaths (FANS) using two techniques: sheath advancement and ureteroscope deflection, along with different sheath and ureteroscope size combinations.
- Results show that maximum deflection angles are significantly different depending on the technique used, with sheath advancement providing the largest angles, although they often fall short of manufacturer expectations.
- The findings suggest that the combination of 11/13Fr sheath with specific ureteroscopes is optimal for achieving better deflection, particularly in difficult lower pole situations; urologists should consider these techniques in practice.
Article Synopsis
- A new digital single-use flexible ureteroscope, the Pusen direct in scope suction (DISS) 7.5Fr, was evaluated in a study across six medical centers for parameters like manoeuvrability, visibility, and efficiency during laser lithotripsy for kidney stones.
- The study included 57 patients with a majority undergoing pre-stenting; results showed a high satisfaction rate among surgeons, with an initial stone free rate of 84.21% and quality parameters rated positively on a Likert scale.
- The Pusen DISS scope demonstrated overall good performance and satisfaction, prompting all participating surgeons to express a willingness to use it in future procedures, indicating potential benefits for future
Adverse events related to laser fibers and laser machines during ureteroscopy and stone lithotripsy: Insights from an updated 10-year analysis of the US MAUDE database.
Arch Ital Urol Androl
October 2024
Article Synopsis
- Ureteroscopy is increasingly used to treat kidney stones, with laser technology being a main component, prompting an analysis of adverse events related to laser fibers and machines in a national database from 2012-2021.
- A total of 699 adverse events involving holmium laser fibers were reported, with the majority caused by breakage—often occurring before laser activation—and leading to a few cancellations of procedures.
- While patient injuries from laser fibers were minimal, operating staff experienced more injuries, primarily superficial burns, highlighting the importance of safety awareness during procedures.
Article Synopsis
- Social media is integral to modern life, influencing interactions between patients and urologists, offering both educational and communication opportunities.
- While patients can benefit from support networks, the accuracy of online health information is often questionable, raising concerns about misinformation.
- For urologists, social media can enhance networking and research but also poses risks, such as mental health impacts and ethical issues regarding patient privacy and consent.
Objective: To evaluate the stone ablation rate and direct thermal damage from thulium fiber laser (TFL) lithotripsy using continuous (C) and burst (B) lasing techniques on an in vitro ureteral model.
Methods: The TFL Drive (Coloplast, Humlebaek, Denmark) was used in an in vitro saline-submerged ureteral model. Ten participants, including five junior and five experienced urologists, conducted the experimental setup with 7 different settings comparing two lasing techniques: steady-state lasing (0.
Article Synopsis
- Kidney stones during pregnancy are rare but difficult to manage, and there's no comprehensive survey on current management practices globally.
- A 19-item survey was developed to evaluate how different regions handle kidney stones in pregnant patients, covering demographics, diagnosis, and treatment options.
- Results showed that most hospitals lack a clear protocol, with ultrasound as the preferred imaging method, but the use of CT scans is growing, especially when ultrasound results are unclear.
Purpose: To examine temporal-spatial distribution of heat generated upon laser activation in a bench model of renal calyx. To establish reference values for a safety distance between the laser fiber and healthy tissue during laser lithotripsy.
Methods: We developed an in-vitro experimental setup employing a glass pipette and laser activation under various intra-operative parameters, such as power and presence of irrigation.
There is a lack of consensus on definitions for the success of endourological stone treatments. The zero-fragment rate (residual fragments [RFs] <1 mm) is now considered more accurate than the stone-free rate (RFs ≤4 mm). As stone volume may be adopted as the recommended method for preoperative estimation of the stone burden, the volumetric stone-free rate may be superior to standard linear RF measurements in defining success.
View Article and Find Full Text PDFArticle Synopsis
- The systematic review focused on assessing the effectiveness and complications of endourological ex vivo stone surgeries in kidney donors with kidney stones, analyzing studies published between 2002 and 2023.
- Out of 1,726 screened abstracts, 16 studies involving 209 patients were included, revealing a high average stone-free rate of 95.4% and a mean surgery duration of 17.3 minutes.
- Complications were minimal, with less than 2% experiencing significant intraoperative or postoperative issues, highlighting these surgeries as a safe and effective option for treating nephrolithiasis in donors.
Social media is increasingly used as a platform for patients to explore health care information. Our objective was to study the content on TikTok in order to gain insight into the perspectives shared by the public on vasectomy. A search was performed using the hashtag ´#vasectomy´ on 12.
View Article and Find Full Text PDFBackground/aim: Management of asymptomatic kidney stones is an ongoing debate with follow-up and treatment guidelines based on low-level evidence. Our aim was to evaluate current management of asymptomatic urinary stones.
Materials And Methods: A 70-question survey was designed in collaboration with European Association of Urology, Young Academic Urologists, Section of Uro-Technology and Section of Urolithiasis groups and distributed.
Purpose: Illumination characteristics of flexible ureteroscopes have been evaluated in air, but not in saline, the native operative medium for endourology. The aim was to evaluate light properties of contemporary ureteroscopes in air versus saline, light distribution analysis, and color temperature.
Methods: We evaluated the Storz Flex-Xc and Flex-X2s, Olympus V3 and P7, Pusen 7.
Introduction: Ionizing radiation is used daily during endourological procedures. Despite the dangers of both deterministic and stochastic effects of radiation, there is a lack of knowledge and awareness among urologists. This study reviewed the literature to identify the radiation exposure (RE) of urologists during endourological procedures.
View Article and Find Full Text PDFPurpose: The aim of the study was to evaluate illumination properties in an in-vitro kidney calyx model in saline.
Design And Methods: We evaluated a series of contemporary flexible ureteroscopes including the Storz Flex-Xc and Flex-X2s, Olympus V3 and P7, Pusen 7.5F and 9.
Article Synopsis
- * Various ureteroscopes were tested, and image quality was analyzed for occurrences of "blackout" (too dark) and "whiteout" (too bright) at different distances and brightness settings.
- * Results showed that some scopes consistently experienced blackout or whiteout, while one model (Flex-Xc) did not, suggesting that these findings could influence urologists’ choice of equipment and settings during procedures.
Purpose: To prospectively evaluate the rate and associated risk factors of early infectious complications after ureterorenoscopy for urolithiasis.
Methods: After ethical committee approval, 400 therapeutic retrograde ureterorenoscopy procedures between August 3, 2020 and November 24, 2021 were included for analysis in a single-center study. Postoperative infection was defined as an afebrile urinary tract infection, fever (≥ 38 °C) with pyuria (≥ 300 WBC/μL) or proven urinary pathogen, and urosepsis.
Purpose: Artifacts from poor ureteroscopes' light design with shadowing and dark areas in the field of view have been reported. The aim was to quantify effects of light obstruction in a kidney calyx model.
Methods: We evaluated a series of contemporary flexible ureteroscopes including the Storz Flex-Xc and Flex-X2s, Olympus V3 and P7, Pusen 7.
Article Synopsis
- - The study aimed to assess radiation protection practices among endourologists in Europe, focusing on compliance with recommendations from the International Commission on Radiation Protection (ICRP) and measuring annual radiation exposure from 2017 to 2020.
- - A survey of 10 endourologists revealed that while most use basic protective gear such as lead aprons and thyroid shields, advanced protections like leaded gloves and glasses are less common; additionally, the mean radiation exposure was below safety thresholds for the chest, eyes, and extremities.
- - The findings indicated that endourologists effectively adhered to radiation safety standards, with the ALARA (As Low As Reasonably Achievable) protocol in place to further minimize exposure during procedures like per