Stone surgery

Question 1

guidewire size

Answer 1

0.035 inches

150cm

Question 2

characteristics guidewire

Answer 2

rigidity
shape memory
torque
conferred by properties material used a tcore

degree surface resistacnce dependent on coating applied

Question 3

starter guidewire

Answer 3

stainless steel core
PTFE coating
flexible tip

Question 4

terumo or glidewire

Answer 4

nitinol with hydrophylic coating

nickel titanium alloy has superior shape memory allow to retain original shape

Question 5

super stiff

Answer 5

nitinol inner core

reinforced with stiffer outer core material

Question 6

sensor guidewire

Answer 6

combination floppy hydrophilic coated tip and a nitinol PTFE coated kind resistant body

Question 7

size baskets

Answer 7

1.3 to 3F
zero tip in calyces

escape 1.9F
zero tip comes in 1.9 to 2.4F to 3F for larger stones

Question 8

length cystoscope

Answer 8

30cm long

17-25Fr

Question 9

lens angle colours

Answer 9

yellow 70
red 30
0 is green

Question 10

semi rigid urs dimentions
length
width
channel of working

Answer 10

fibre optic image
34 cm long working element
7-10Fr Tip
channel often 3.4 fr or if two channels will be 2.3Fr each

These instruments use the same coherent image bundle and noncoherent illumination
bundle technology as fl exible scopes but are housed in a semi-rigid metal skin
rather than fl exible vertebrae; they do not defl ect at the tip. Manufactures turn to
semi-rigid telescopes for longer or smaller diameter scopes. In the case of a semirigid
ureteroscope, the design allows a degree of malleability whilst maintaining the
rigidity to advance up a torturous ureter. Semi-rigid telescopes are often used in
paediatric endoscopes where the scope diameters are between 1 and 2 mm. It is possible
to make rod-lens systems this size, but their relative fragility necessitates a
compromise between the optical view and durability.

Question 11

flexible urs dimensions

Answer 11

fibre optic image
7-80cm long
5.4-9Fr tup
channel often 3.4 Fr

access sheath navigator comes in 13/15
12/14 and 11/13 with lengths 28cm, 36cm, 46cm

Question 12

access sheath

Answer 12

35-45 cm

10-14Fr

Question 13

fibre optics

Answer 13

flexible glass or plastic to allow light transmission
process of TIR, little loss light intensity
light leads are non coherent
image transmission is cohernt

A single glass fi bre when stretched to 1/100 mm in diameter and
combined with multiple fi bres in an ordered, coherent bundle can transmit a complete,
but compound, image.

Question 14

how many fibres in flexible urs

Answer 14

fl exible ureterorenoscope has around 4,000 fi bres in

the bundle and can defl ect 270° in both directions at the tip.

Question 15

whats inside flexible endoscope

Answer 15

In addition to the coherent fibre bundle for vision, there is a separate noncoherent
bundle that transmits the light into the body cavity, an instrument channel to allow
irrigation and instrumentation and two control wires that are connected to the defl ection
leaver to control the distal tip up and down (Fig. 40.1 ). All of these elements are
free to move independently of each other housed in the vertebrae of the scope as it
fl exes. An outer cover maintains a water-tight environment, allowing the scope to be
effectively cleaned. Any leaks in the outer cover or inner working channel will
allow fl uid ingress into the scope which will affect the view and ultimately seize up
the moving parts. It is important to leak test the scope before every use as fl uid
ingress is also a potential cross contamination risk.

Question 16

digital endoscopes

Answer 16

Traditionally, any image made through a fl exible endoscope is viewed on a monitor;
this necessitates attaching a camera head to the eyepiece of the scope where it is
converted to a digital format. However, good your camera is, the image will be limited
by the fi bre-optic system of the telescope. With the miniaturisation of chargecoupled
device (CCD) and complementary metal–oxide–semiconductor (CMOS)
video chips, it is now possible to mount the chip at the distal tip of the telescope
without increasing the overall size of the telescope. Removing the optical fi bres and
placing the chip at the source have dramatically improved the quality of images
available from a fl exible endoscope.

Question 17

size of digitial chip on end flexible urs

Answer 17

8.5Fr
using latest CMOS technology complementary metal oxide semi conductor video chups
also has 270 deflection

8.5Fr fl exible ureterorenoscopes utilise the latest CMOS technology to produce
stunning images of the upper tract without compromising on the external size,
instrument channel or 270° up/down defl ection (Fig. 40.2 ). LED illumination technology
is incorporated into the body of the handpiece, and light is transmitted into
the patient by a conventional noncoherent fi bre bundle. This eliminates the need for
a light guide cable, thus reducing the weight of the instrument and improving its fi ne
manipulation during surgery.
But often thicker

Question 18

light tramission in cystoscope

Answer 18

A noncoherent glass fi bre system to transmit light into the patient and illuminate
the cavity under view. The fi bre bundle runs through an outer shell of the telescope
from the light post to the distal tip and uses the same type of fi bres as in a
fi bre-optic light cable.

Question 19

how is image generated on ditial scope

Answer 19

photons striking charge coupled device i.e. chip on tip

Question 20

baskets for stone surgery

Answer 20

tipped or flat wire
or tipless
made of nitinol
2 to 3.2 Fr
open in parachute or helical ways

Question 21

access sheath

Answer 21

navigator 12/14F x 46cm sheath length
with insert is 50cm
inside diameter 12F
guidewire allows up to 0.038 inches

Question 22

escape basket

Answer 22

nitnol
only 1.9F so can fit 200u laser fibre along side
traditional 2.4F basket
In a 3.6F working channel, the 1.9F sheath and 200µ holmium laser fiber together intended to provide irrigation flow equivalent to a 2.4F device

Question 23

dakota basket

Answer 23

boston

3 wires form the shape

Question 23

pusen reusable scope working channel

Answer 23

3.6 Fr working channel
self locking mechanism
270 degree deflection

Question 24

components cystoscope

Answer 24

telescope
sheath
bridge
obturator