EURURO-7540; No. of Pages 1 E U R O P E A N U R O L O G Y X X X ( 2 0 17 ) X X X – X X X
available at www.sciencedirect.com journal homepage: www.europeanurology.com
Words of Wisdom Re: The Use of Apnea During Ureteroscopy Emiliani E, Talso M, Baghdadi M, et al Urology 2016;97:266–8 Expert’s summary: In this “surgeon’s workshop” paper, the authors describe their technique for perioperative apnea during retrograde intrarenal surgery (RIRS) for laser treatment of stones and various other diseases. Ventilation was interrupted for a few minutes to limit renal movements due to diaphragmatic displacements, and consequently facilitate the surgeon’s work. General anesthesia was always achieved, with administration of intravenous propofol and remifentanil associated with insertion of a supraglottic airway device. A few minutes before the initiation of apnea, the patient was ventilated with 100% oxygen (preoxygenation). Inhalational anesthetics were prohibited to prevent the risk of the patient awakening during the procedure. Interruption of ventilation allowed maintenance of apnea for approximately 3–5 min. Apnea could be repeated during the procedure, alternating with periods of preoxygenation. No postoperative complications were observed. The clinical results of this strategy were not assessed. Expert’s comments: RIRS with laser fragmentation is currently the technique most frequently used for the treatment of renal stones of
available at www.sciencedirect.com journal homepage: www.europeanurology.com
Words of Wisdom Re: The Use of Apnea During Ureteroscopy Emiliani E, Talso M, Baghdadi M, et al Urology 2016;97:266–8 Expert’s summary: In this “surgeon’s workshop” paper, the authors describe their technique for perioperative apnea during retrograde intrarenal surgery (RIRS) for laser treatment of stones and various other diseases. Ventilation was interrupted for a few minutes to limit renal movements due to diaphragmatic displacements, and consequently facilitate the surgeon’s work. General anesthesia was always achieved, with administration of intravenous propofol and remifentanil associated with insertion of a supraglottic airway device. A few minutes before the initiation of apnea, the patient was ventilated with 100% oxygen (preoxygenation). Inhalational anesthetics were prohibited to prevent the risk of the patient awakening during the procedure. Interruption of ventilation allowed maintenance of apnea for approximately 3–5 min. Apnea could be repeated during the procedure, alternating with periods of preoxygenation. No postoperative complications were observed. The clinical results of this strategy were not assessed. Expert’s comments: RIRS with laser fragmentation is currently the technique most frequently used for the treatment of renal stones of
