New live surgery techniques at EULIS17

17 August 2017

One of the esteemed, international experts who will conduct live surgeries during the upcoming EULIS17 meeting is Prof. Guohua Zeng, a professor and Consultant Urologist at The First Affiliated Hospital of Guangzhou Medical University.

During EULIS17, live surgeries will be broadcasted from two locations: Vienna, Austria and Pforzheim, Germany. Prof. Zeng will perform the procedure super-mini PCNL (SMP), one of eight surgeries that will take place in Vienna. He said, “These live surgeries will show new techniques in kidney-stone removal. My colleagues Prof. Jens Rassweiler will perform a robotic retrograde intrarenal surgery, and Prof. Cesare Marco Scoffone will perform endoscopic combined intrarenal surgery (ECIRS) in supine position. I believe fellow urologists will find these new techniques useful and stimulating.”

The procedure
Prof. Zeng will perform an SMP with a newly-designed irrigation-suction sheath. He explained, “I developed the irrigation-suction sheath as a simple solution for improving the irrigation and stone clearance during SMP. The irrigation-suction sheath is a two-layered metal structure. The space between the two layers of the sheath forms an independent irrigation channel. Using this new-generation SMP system, the irrigation is delivered through the sheath and therefore freeing up a working channel space of the nephroscope. This allows utilizing larger instruments (as 550 um laser fiber or 1.0 mm lithotripter) without reducing irrigation efficacy. Furthermore, the irrigation-suction sheath allows the inflow and outflow separately that create a one-way flow to remove the stone, which I think it is a revolutionary approach to improve the stone removal in recent miniaturized PCNL techniques.”

Preventing complications
According to Prof. Zeng, infection is one of the feared complications of stone surgery. He stated, “I recommend that stone culture should be performed in patients who possess the risk factors for urosepsis such as positive preoperative urine culture, positive pelvic urine culture, and large or complex stone burden. Stone cultures have shown to be better predictors of sepsis and systemic inflammatory response syndrome, than voided cultures. The utility of obtaining stone cultures in clinical practice can guide antibiotic choice in the event of sepsis following stone surgery.”

Upcoming breakthroughs
“Miniaturized percutaneous nephrostolithotomy (PCNL) systems and disposable flexible ureteroscope will develop rapidly with board prospects in the coming five to ten years,” predicted Prof. Zeng. He further explained that despite the successful of recent miniaturized PCNL techniques, these still have several limitations that should be solved such as a low efficacy in treatment of complex stones. He said “In the future, the focus should be on how to improve stone removal and operative time in miniaturized PCNL techniques when treating complex stones.”

Prof. Zeng added that Flexible Ureterorenoscopy (fURS) has recently become an attractive option for surgical management of kidney stones. However, the durability of flexible ureteroscope still remains a major concern. He pointed out that due to the high cost and limited durability, the cost-benefit of non-disposable flexible ureteroscope continues to be the most important factor for initiating and maintaining fURS programs worldwide, especially in developing countries. “Nowadays, disposable digital flexible ureterscopes are available which offer an improved image resolution. These are more economical as sterilization and repair are unnecessary. I think the disposable flexible ureteroscopes will be widely used in the future.”

Look forward to Prof. Zeng’s presentation at EULIS17 along with other reputable experts at the meeting, and check more information on the meeting’s comprehensive Scientific Programme.