Biomedical subjects
Publications and source records attributed to J W Demler.
Successful stone manipulation was facilitated with the new monofilament basket in experimental situations and in patients. Advantages over other baskets include: in vivo adjustability, reduced mucosal trauma, ability to irrigate and aspirate through the basket, and ability to pass lithotriptor electrodes within the basket. Basket modifications under study might prove useful within the ureter, renal pelvis, and biliary tree.
A total of 14 patients with extensive bilateral nephrolithiasis underwent simultaneous bilateral lithotomy, in most instances through a single transabdominal incision. Anatrophic nephrolithotomy was performed on 25 kidneys, while 3 kidneys were approached in other ways without formal hypothermia and ischemia. There was no statistically significant change in the average preoperative and postoperative serum creatinine values (p greater than 0.1). There were residual stone fragments in 2 of the 28 kidneys (7 per cent) and stones recurred in 3 others (11 per cent) during the followup period (average 12 months). Of the 14 patients 10 (71 per cent) had infected urine preoperatively and 9 (64 per cent) have been free of infection postoperatively. There were no operative deaths and the average postoperative hospital stay was 17.6 days. We herein demonstrate that bilateral renal surgery for stone removal in 1 operative session can be performed safely with results comparable to those of unilateral staged procedures using other approaches. The advantages of this type of surgical management are discussed.