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Erschienen in: World Journal of Urology 5/2016

10.09.2015 | Original Article

The hydrodynamic basis of the vacuum cleaner effect in continuous-flow PCNL instruments: an empiric approach and mathematical model

verfasst von: R. Mager, C. Balzereit, K. Gust, T. Hüsch, T. Herrmann, U. Nagele, A. Haferkamp, D. Schilling

Erschienen in: World Journal of Urology | Ausgabe 5/2016

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Abstract

Purpose

Passive removal of stone fragments in the irrigation stream is one of the characteristics in continuous-flow PCNL instruments. So far the physical principle of this so-called vacuum cleaner effect has not been fully understood yet. The aim of the study was to empirically prove the existence of the vacuum cleaner effect and to develop a physical hypothesis and generate a mathematical model for this phenomenon.

Methods

In an empiric approach, common low-pressure PCNL instruments and conventional PCNL sheaths were tested using an in vitro model. Flow characteristics were visualized by coloring of irrigation fluid. Influence of irrigation pressure, sheath diameter, sheath design, nephroscope design and position of the nephroscope was assessed. Experiments were digitally recorded for further slow-motion analysis to deduce a physical model.

Results

In each tested nephroscope design, we could observe the vacuum cleaner effect. Increase in irrigation pressure and reduction in cross section of sheath sustained the effect. Slow-motion analysis of colored flow revealed a synergism of two effects causing suction and transportation of the stone. For the first time, our model showed a flow reversal in the sheath as an integral part of the origin of the stone transportation during vacuum cleaner effect. The application of Bernoulli’s equation provided the explanation of these effects and confirmed our experimental results.

Conclusions

We widen the understanding of PCNL with a conclusive physical model, which explains fluid mechanics of the vacuum cleaner effect.
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Literatur
3.
Zurück zum Zitat Mager R, Balzereit C, Reiter M, Gust K, Borgmann H, Husch T, Nagele U, Haferkamp A, Schilling D (2015) Introducing a novel in vitro model to characterize hydrodynamic effects of PCNL systems. J Endourol. doi:10.1089/end.2014.0854 PubMed Mager R, Balzereit C, Reiter M, Gust K, Borgmann H, Husch T, Nagele U, Haferkamp A, Schilling D (2015) Introducing a novel in vitro model to characterize hydrodynamic effects of PCNL systems. J Endourol. doi:10.​1089/​end.​2014.​0854 PubMed
4.
Zurück zum Zitat Nagele U, Horstmann M, Sievert KD, Kuczyk MA, Walcher U, Hennenlotter J, Stenzl A, Anastasiadis AG (2007) A newly designed amplatz sheath decreases intrapelvic irrigation pressure during mini-percutaneous nephrolitholapaxy: an in vitro pressure-measurement and microscopic study. J Endourol 21(9):1113–1116. doi:10.1089/end.2006.0230 CrossRefPubMed Nagele U, Horstmann M, Sievert KD, Kuczyk MA, Walcher U, Hennenlotter J, Stenzl A, Anastasiadis AG (2007) A newly designed amplatz sheath decreases intrapelvic irrigation pressure during mini-percutaneous nephrolitholapaxy: an in vitro pressure-measurement and microscopic study. J Endourol 21(9):1113–1116. doi:10.​1089/​end.​2006.​0230 CrossRefPubMed
6.
Zurück zum Zitat Hinman F Jr (1961) Peripelvic extravasation during intravenous urography, evidence for an additional route for backflow after ureteral obstruction. J Urol 85:385–395PubMed Hinman F Jr (1961) Peripelvic extravasation during intravenous urography, evidence for an additional route for backflow after ureteral obstruction. J Urol 85:385–395PubMed
7.
8.
Zurück zum Zitat Nagele U, Schilling D, Sievert KD, Stenzl A, Kuczyk M (2008) Management of lower-pole stones of 0.8 to 1.5 cm maximal diameter by the minimally invasive percutaneous approach. J Endourol 22(9):1851–1853. doi:10.1089/end.2008.9791 (discussion 1857) CrossRefPubMed Nagele U, Schilling D, Sievert KD, Stenzl A, Kuczyk M (2008) Management of lower-pole stones of 0.8 to 1.5 cm maximal diameter by the minimally invasive percutaneous approach. J Endourol 22(9):1851–1853. doi:10.​1089/​end.​2008.​9791 (discussion 1857) CrossRefPubMed
9.
Zurück zum Zitat Schilling D, Husch T, Bader M, Herrmann TR, Nagele U (2015) Nomenclature in PCNL or The Tower Of Babel: a proposal for a uniform terminology. World J Urol. doi:10.1007/s00345-015-1506-7 Schilling D, Husch T, Bader M, Herrmann TR, Nagele U (2015) Nomenclature in PCNL or The Tower Of Babel: a proposal for a uniform terminology. World J Urol. doi:10.​1007/​s00345-015-1506-7
10.
Zurück zum Zitat Abdelhafez MF, Bedke J, Amend B, ElGanainy E, Aboulella H, Elakkad M, Nagele U, Stenzl A, Schilling D (2012) Minimally invasive percutaneous nephrolitholapaxy (PCNL) as an effective and safe procedure for large renal stones. BJU Int 110(11 Pt C):E1022–E1026. doi:10.1111/j.1464-410X.2012.11191.x CrossRefPubMed Abdelhafez MF, Bedke J, Amend B, ElGanainy E, Aboulella H, Elakkad M, Nagele U, Stenzl A, Schilling D (2012) Minimally invasive percutaneous nephrolitholapaxy (PCNL) as an effective and safe procedure for large renal stones. BJU Int 110(11 Pt C):E1022–E1026. doi:10.​1111/​j.​1464-410X.​2012.​11191.​x CrossRefPubMed
11.
Zurück zum Zitat Zhong W, Zeng G, Wu K, Li X, Chen W, Yang H (2008) Does a smaller tract in percutaneous nephrolithotomy contribute to high renal pelvic pressure and postoperative fever? J Endourol 22(9):2147–2151. doi:10.1089/end.2008.0001 CrossRefPubMed Zhong W, Zeng G, Wu K, Li X, Chen W, Yang H (2008) Does a smaller tract in percutaneous nephrolithotomy contribute to high renal pelvic pressure and postoperative fever? J Endourol 22(9):2147–2151. doi:10.​1089/​end.​2008.​0001 CrossRefPubMed
12.
15.
Zurück zum Zitat Nicklas AP, Nagele U (2014) The “vacuum cleaner effect” in minimal invasive nephrolitholapaxy (MIP)—illustration of the effect by computational fluid dynamics. Eur Urol Suppl 13(1):e612. doi:10.1016/S1569-9056(14)60602-3 CrossRef Nicklas AP, Nagele U (2014) The “vacuum cleaner effect” in minimal invasive nephrolitholapaxy (MIP)—illustration of the effect by computational fluid dynamics. Eur Urol Suppl 13(1):e612. doi:10.​1016/​S1569-9056(14)60602-3 CrossRef
16.
Zurück zum Zitat Lehman DS, Hruby GW, Phillips C, Venkatesh R, Best S, Monga M, Landman J (2008) Prospective randomized comparison of a combined ultrasonic and pneumatic lithotrite with a standard ultrasonic lithotrite for percutaneous nephrolithotomy. J Endourol 22(2):285–289. doi:10.1089/end.2007.0009 CrossRefPubMed Lehman DS, Hruby GW, Phillips C, Venkatesh R, Best S, Monga M, Landman J (2008) Prospective randomized comparison of a combined ultrasonic and pneumatic lithotrite with a standard ultrasonic lithotrite for percutaneous nephrolithotomy. J Endourol 22(2):285–289. doi:10.​1089/​end.​2007.​0009 CrossRefPubMed
17.
Zurück zum Zitat Desai J, Solanki R (1010) Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU Int 112(7):1046–1049. doi:10.10.1111/bju.12193 (Epub 12013 Jul 12111) Desai J, Solanki R (1010) Ultra-mini percutaneous nephrolithotomy (UMP): one more armamentarium. BJU Int 112(7):1046–1049. doi:10.​10.​1111/​bju.​12193 (Epub 12013 Jul 12111)
18.
Zurück zum Zitat Vuong B, Genis H, Wong R, Ramjist J, Jivraj J, Farooq H, Sun C, Yang VX (2014) Evaluation of flow velocities after carotid artery stenting through split spectrum Doppler optical coherence tomography and computational fluid dynamics modeling. Biomed Opt Express 5(12):4405–4416. doi:10.1364/BOE.5.004405 CrossRefPubMedPubMedCentral Vuong B, Genis H, Wong R, Ramjist J, Jivraj J, Farooq H, Sun C, Yang VX (2014) Evaluation of flow velocities after carotid artery stenting through split spectrum Doppler optical coherence tomography and computational fluid dynamics modeling. Biomed Opt Express 5(12):4405–4416. doi:10.​1364/​BOE.​5.​004405 CrossRefPubMedPubMedCentral
Metadaten
Titel
The hydrodynamic basis of the vacuum cleaner effect in continuous-flow PCNL instruments: an empiric approach and mathematical model
verfasst von
R. Mager
C. Balzereit
K. Gust
T. Hüsch
T. Herrmann
U. Nagele
A. Haferkamp
D. Schilling
Publikationsdatum
10.09.2015
Verlag
Springer Berlin Heidelberg
Erschienen in
World Journal of Urology / Ausgabe 5/2016
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1682-5

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