Efficacy and safety of ultrasonic longitudinal-axis vibration for the reduction of ureteral access sheath insertion force

A randomized controlled trial in a porcine model

Kyo Chul Koo, Kwang Suk Lee, Gyu Rang Min, Hye Sun Lee, Beom Jin Lim, Ji Sup Kim, Dong Wook Kim, No Cheol Park

Research output: Contribution to journalArticle

Abstract

Purpose: Excessive bulking force during ureteral access sheath (UAS) placement may induce injury. The sliding friction between surfaces can be reduced with the application of ultrasonic vibration. We investigated the efficacy and safety of an ultrasonic vibration transducing device for reducing the maximal ureteral access sheath insertion force (UASIF). Materials and Methods: A device was developed for transducing ultrasonic longitudinal-axis vibration onto the UAS at an adjustable amplitude and frequency while measuring the degree of UASIF. In the pilot study, six porcine models were used to investigate the optimal amplitude and frequency of vibration and to calculate sample size. Twelve porcine models were utilized in a randomized controlled trial. Resected ureters were pathologically evaluated for ureteral injury. Results: The transduction of ultrasonic vibration at an amplitude of 0.04 g and a frequency of 18,000 Hz resulted in a maximal UASIF reduction of 36.4% (interquartile range 32.7-43.1). Maximal UASIF tended to decrease with increasing vibration frequency. No significant differences in UASIF reductions were observed according to amplitude. In the randomized controlled trial, the maximal UASIF reduction was 37.0% (interquartile range 21.4-44.2). Grade II injury was pathologically diagnosed in 8.3% (1/12) of the ureters in both groups. Conclusions: The transduction of ultrasonic longitudinal-axis vibration onto the UAS reduces maximal UASIF and does not harm the ureter. Reducing the velocity of sheath insertion may further reduce maximal UASIF.

Original languageEnglish
Pages (from-to)140-145
Number of pages6
JournalJournal of Endourology
Volume33
Issue number2
DOIs
Publication statusPublished - 2019 Feb 1

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Vibration
Ultrasonics
Swine
Ureter
Randomized Controlled Trials
Safety
Wounds and Injuries
Equipment and Supplies
Friction
Sample Size
Ultrasonic Waves

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Koo, Kyo Chul ; Lee, Kwang Suk ; Min, Gyu Rang ; Lee, Hye Sun ; Lim, Beom Jin ; Kim, Ji Sup ; Kim, Dong Wook ; Park, No Cheol. / Efficacy and safety of ultrasonic longitudinal-axis vibration for the reduction of ureteral access sheath insertion force : A randomized controlled trial in a porcine model. In: Journal of Endourology. 2019 ; Vol. 33, No. 2. pp. 140-145.
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abstract = "Purpose: Excessive bulking force during ureteral access sheath (UAS) placement may induce injury. The sliding friction between surfaces can be reduced with the application of ultrasonic vibration. We investigated the efficacy and safety of an ultrasonic vibration transducing device for reducing the maximal ureteral access sheath insertion force (UASIF). Materials and Methods: A device was developed for transducing ultrasonic longitudinal-axis vibration onto the UAS at an adjustable amplitude and frequency while measuring the degree of UASIF. In the pilot study, six porcine models were used to investigate the optimal amplitude and frequency of vibration and to calculate sample size. Twelve porcine models were utilized in a randomized controlled trial. Resected ureters were pathologically evaluated for ureteral injury. Results: The transduction of ultrasonic vibration at an amplitude of 0.04 g and a frequency of 18,000 Hz resulted in a maximal UASIF reduction of 36.4{\%} (interquartile range 32.7-43.1). Maximal UASIF tended to decrease with increasing vibration frequency. No significant differences in UASIF reductions were observed according to amplitude. In the randomized controlled trial, the maximal UASIF reduction was 37.0{\%} (interquartile range 21.4-44.2). Grade II injury was pathologically diagnosed in 8.3{\%} (1/12) of the ureters in both groups. Conclusions: The transduction of ultrasonic longitudinal-axis vibration onto the UAS reduces maximal UASIF and does not harm the ureter. Reducing the velocity of sheath insertion may further reduce maximal UASIF.",
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Efficacy and safety of ultrasonic longitudinal-axis vibration for the reduction of ureteral access sheath insertion force : A randomized controlled trial in a porcine model. / Koo, Kyo Chul; Lee, Kwang Suk; Min, Gyu Rang; Lee, Hye Sun; Lim, Beom Jin; Kim, Ji Sup; Kim, Dong Wook; Park, No Cheol.

In: Journal of Endourology, Vol. 33, No. 2, 01.02.2019, p. 140-145.

Research output: Contribution to journalArticle

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T1 - Efficacy and safety of ultrasonic longitudinal-axis vibration for the reduction of ureteral access sheath insertion force

T2 - A randomized controlled trial in a porcine model

AU - Koo, Kyo Chul

AU - Lee, Kwang Suk

AU - Min, Gyu Rang

AU - Lee, Hye Sun

AU - Lim, Beom Jin

AU - Kim, Ji Sup

AU - Kim, Dong Wook

AU - Park, No Cheol

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N2 - Purpose: Excessive bulking force during ureteral access sheath (UAS) placement may induce injury. The sliding friction between surfaces can be reduced with the application of ultrasonic vibration. We investigated the efficacy and safety of an ultrasonic vibration transducing device for reducing the maximal ureteral access sheath insertion force (UASIF). Materials and Methods: A device was developed for transducing ultrasonic longitudinal-axis vibration onto the UAS at an adjustable amplitude and frequency while measuring the degree of UASIF. In the pilot study, six porcine models were used to investigate the optimal amplitude and frequency of vibration and to calculate sample size. Twelve porcine models were utilized in a randomized controlled trial. Resected ureters were pathologically evaluated for ureteral injury. Results: The transduction of ultrasonic vibration at an amplitude of 0.04 g and a frequency of 18,000 Hz resulted in a maximal UASIF reduction of 36.4% (interquartile range 32.7-43.1). Maximal UASIF tended to decrease with increasing vibration frequency. No significant differences in UASIF reductions were observed according to amplitude. In the randomized controlled trial, the maximal UASIF reduction was 37.0% (interquartile range 21.4-44.2). Grade II injury was pathologically diagnosed in 8.3% (1/12) of the ureters in both groups. Conclusions: The transduction of ultrasonic longitudinal-axis vibration onto the UAS reduces maximal UASIF and does not harm the ureter. Reducing the velocity of sheath insertion may further reduce maximal UASIF.

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