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
- TIME SAVINGS
- INITIAL- Before the procedure.
- DURING – During the procedure.
- LESS Equipment.
- LESS Complications.
- LESS Need For Personnel.
UPIS
- INITIAL BEFORE THE PROCEDURE.
- All Devices Require ASSEMLY on the Table.
- UPIS requires NO ASSEMBLY.
- DURING THE PROCEDURE.
- CUMBERSOME DEVICE VS COMPACT DEVICE.
- Irrigation Time cut in Half with UPIS.
- 3 hands operation.
- Hand and Foot operation.
- Engaging and Disengaging ports.
- 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
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!