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Biomedical subjects

M Kuenkel

Publications and source records attributed to M Kuenkel.

8 recordsLinked to original sources
PubMed1997

Endostent: new device for ureteral strictures.

The results with the new Korth Endostent (manufactured by Rüsch), which was placed in 71 ureters after endopyelotomy, were compared with the results of conventional stenting in 183 ureters. Good or excellent results were seen in 79% of the Endostented ureters v 73% of the conventionally stented ureters. With conventional stents, results were better in primary than in secondary stenoses, whereas the reverse was true with the Endostent. The Endostent provided superior results in patients with third-degree hydronephrosis and in those with long scars. There was a striking reduction in the risk of infection (fever) in patients having an Endostent inserted (7% v 44%). The Endostent may also be indicated for permanent implantation in patients with strictures of ureterovesical anastomoses involving neobladders or allograft kidneys.

Adolescent↗
PubMed1996

Percutaneous endopyelotomy and results: Korth technique.

Endoscopic incision of ureteral strictures has become an important component of the urologic armamentarium. Despite different techniques and stenting times applied for the procedures, the rates of long-term favorable outcomes have proved to range consistently from 72% to 89% for both secondary and primary hydronephrosis. Cold-knife incision combined with 3 weeks of stenting has been utilized at our institution from the beginning. The results have been as favorable as those from other groups. However, stenting times are the subject of controversy. In a prospective trial, a newly designed stent for internal reflux-free drainage and subcutaneous fixation was applied in 53 patients and left indwelling for 6 months. Whereas such long-term stenting using the Endostent seemed to produce less favorable overall results, stenting for 3 weeks proved sufficient in lower-grade hydronephrosis secondary to small stenotic ureteral segments. Although stenoses recurred in 12% of our cases, 90% of these recurrences could be treated endoscopically. All but two recurrences became evident within the first 6 months after stent removal. After a mean follow-up of 20.2 +/- 19.6 months, the outcomes have remained unchanged even on late reexamination.

Adolescent↗
PubMed1995

The optical "Veress-needle"--initial puncture with a minioptic.

Laparoscopic access is a necessary part of minimally invasive surgery. The double blind puncture with Veress-needle and trocar can cause lethal complications such as bowel injury, bleeding and gas-embolisation. Some authors have reported alternative techniques for laparoscopic abdominal access. Because no blind procedure can absolutely prevent injury, permanent visual control of perforated tissue layers as in open surgery should be achieved to prevent possible injury at an early stage. Previously described procedures could not fulfil all requirements to comply with this ideal, i.e. permanent visual control of abdominal wall penetration prior to establishment of pneumoperitoneum and trocar insertion without further possible damage. We designed a 2 mm fibreglass optic 250 mm in length that is inserted into a suitable cannula. Special construction allows rinsing through the cannula to clear the vision and to open spaces in the puncture track by water dissection. After incision of the skin, all layers of the abdominal wall can be visualised, including blood vessels and internal surfaces. Once the abdominal cavity is reached, the needle tip is retracted and a two-step dilation allows the trocar to be introduced via the puncture track. Only then does insufflation begin. The fibreglass optic-equipped safety needle was used for visually controlled access in 184 laparoscopic surgical procedures. After a period of training, all layers of the abdominal wall could be recognised exactly. In two patients with dense adhesions, perforation of the small bowel was diagnosed immediately by endoscopic viewing. The small injury needed no treatment, and the intended procedure was completed laparoscopically.(ABSTRACT TRUNCATED AT 250 WORDS)

Catheterization↗
PubMed1992

The "TUR-Catheter", a new catheter for postoperative drainage of the bladder.

A new catheter for postoperative irrigation of the bladder after operation of the prostate or bladder is introduced. Instead of 1 to 3 large holes measuring 5.5-6.5 mm by 2.5-3 mm at its tip, as in common catheters, it has 32 drainage holes, each of them measuring 1.5 mm in diameter. This type of construction still secures sufficient unhindered drainage of the bladder, even if the majority of holes is obstructed. Thus, postoperative tamponade is prevented.

Drainage↗
PubMed1988

Percutaneous pyeloplasty.

The indication for and the technique of the percutaneous operation on strictures at the ureteropelvic junction are reported on 120 patients. The results of evaluation of 66 followed-up cases are presented. The new method proves to be superior to open surgery in secondary (acquired) stenoses with a success rate of 89 per cent, whereas in congenital stenosis the success rate was 75 per cent. However, if this simple and safe technique does fail, open plastic surgery still can be performed.

Anesthesia, Local↗
PubMed1988

Percutaneous reanastomosis of transplant kidney.

A successful percutaneous reanastomosis of a transplanted kidney is reported. The kidney already had been operated on several times. The kidney-ureter anastomosis was occluded. Using a combination of ureteroscopy and the percutaneous technique, the old anastomosis was bypassed, and a new one was made.

Adult↗
PubMed1988

Unusual applications of ureteroscopy.

Six cases of combined percutaneous and ureteroscopic opening or reanastomosis of completely occluded ureters are described. All patients had previously had nephrostomy tubes inserted to salvage their kidneys.

Adult↗