PPT presentations

UNIVERSAL PIGGYBACK IRRIGATION SYSTEM

UNIVERSAL PIGGYBACK
IRRIGATION SYSTEM (UPIS)

Avtar Dhindsa M.D.

UPIS

Need for Irrigation in Ureteroscopy

VISUALISATION

DILATION

UPIS

Present Irrigation System

1) Pressurized Cuff

2) Manual Syringe Irrigation

3) Hand Held Irrigation Pump

4) Foot Pump

5) Electronic Pumps

UPIS

Pressurized Cuff

ADVANTAGE

High Pressure Good Visualization

DISADVANTAGE

Use of Both Hands, Lack of Precise Control

UPIS

Manual Syringe Irrigation System

ADVANTAGE

Slightly Better Control

DISADVANTAGE

Need for TWO Assistants

Control In The Assistant’s Hand

UPIS

Hand Held Irrigation Pumps

ADVANTAGE

Better Control

DISADVANTAGE

Requires Assembly

Use of TWO Hands/ Assistant (PAIN and INJURY)

Bulky, Tubes Kink, Cumbersome

UPIS

Roller Pumps, Electronic Pumps

ADVANTAGE

Able to Provide Flow at a Constant Rate

DISADVANTAGE

Difficult To Slow Down

Expensive

Need of TWO hands

UPIS

FOOT PUMP

ADVANTAGE

NONE

DISADVANTAGE

Too many controls with the FOOT

Need an Assistant to slow the Flow

CUMBERSOME

Accidental Firing of Laser

ERGONOMICS

UNIVERSAL PIGGYBACK IRRIGATION SYSTEM (UPIS)

  • PRECISION CONTROL BY A SURGEON WITH A SINGLE HAND.
  • ONE HAND COMPLETELY FREE FOR PROCEDURES.
  • SUPERIOR ERGONOMICS.
  • COMPATABLE WITH ALL URETEROSCOPES.
  • MULTIFUNCTIONAL.
  • ELIMINATES MANY ACESSORIES.
  • MANY COST SAVINGS.

UPIS

Cost Savings are at Multiple Levels

  1. TIME SAVINGS
    1. INITIAL- Before the procedure.
    2. DURING – During the procedure.
  2. LESS Equipment.
  3. LESS Complications.
  4. LESS Need For Personnel.

UPIS

  1. INITIAL BEFORE THE PROCEDURE.
    1. All Devices Require ASSEMLY on the Table.
    2. UPIS requires NO ASSEMBLY.
  2. DURING THE PROCEDURE.
    1. CUMBERSOME DEVICE VS COMPACT DEVICE.
    2. Irrigation Time cut in Half with UPIS.
    3. 3 hands operation.
    4. Hand and Foot operation.
    5. Engaging and Disengaging ports.
    6. Comes with a Toughy Bhorst.

UPIS

LESS EQUIPMENT

  • ELIMINATES MANY ACCESSORIES.
    • CONE TIP CATHETERS
    • OPEN-ENDED CATHETERS
    • DUAL-LUMEN CATHETERS
    • INJECTION CATHETERS
  • COMES WITH A TOUGHY BORST.

UPIS

LESS COMPLICATIONS

  • Engaging/Disengaging Ports.
  • Injection Port is Multifunctional.
  • Stone Migration → ESWL.

UPIS

LESS PERSONNEL

  • Fewer Employees

UPIS

SAVINGS

LESS TIME → SAVES OR TIME → SAVES MONEY

LESS EQUIPMENT → LESS INVENTORY → SAVES MONEY

LESS COMPLICATIONS → SAFER PROCEDURE → SAVES MONEY

LESS PERSONNEL → FEWER EMPLOYEES → SAVES MONEY

UPIS

BOTTOM LINE

LESS TIME → SAVES MONEY

LESS EQUIPMENT → SAVES MONEY

LESS COMPLICATIONS → SAVES MONEY

LESS PERSONNEL → SAVES MONEY

UPIS

Management of Stone Disease, Past Present & Future

Management of Stone
Disease.
Past, Present, and Future

Avtar Dhindsa M.D.

Past is open surgery.

Present is Endoscopic.

Future is Refinement

of the present.

Present will merge into the Future.

The UPIS.

Dye test

Components of Endoscopic Management.

  • Ureteroscope.
  • Guide wires.
  • Fragmentation Modalities.
  • Irrigation. → UPIS
  • Traps and Extraction devices.

 

 

Retropulsion!!!

RETROPULSION !!!!

Primary Cause.

Irrigation

Laser.

Secondary Cause.

URETER.

Secondary Cause

URETER

UROTHELIUM

MUSCULAR WALL

SIZE OF THE LUMEN

URETERAL ANATOMY

COMPLIANCE

RESISTANCE

CURRENT DEVICES #1

CURRENT DEVICES #2

Solving Retropulsion.

1) Reduce 5 steps to 1 or 2.

2) Do not compromise the lumen

3) Overcome the limitations of the Ureter

4) Is it possible to make a device like this?

Yes!