7° Congresso Nazionale

7° Congresso Nazionale Associazione Italiana di Endourologia
Mini-percutaneous procedure (MIPP): a new set.
Summary
Antonio Frattini, Stefania Ferretti, Paolo Salsi, Umberto Maestroni, Pietro Cortellini
Urology Unit, Azienda Ospedaliero-Universitaria of Parma, Italy
Objective: We are presenting our instrumental set for mini-percutaneous procedure
(MIPP-set), manufactured in collaboration with RÜSCH Medical Company, along with
our indications and clinical experience.
Methods: From January 2002 to December 2006, we treated with MIPP, 63 patients,
range 2-76 years. Percutaneous lithotripsy was performed in 57/63 patients, for stones
of 21 ± 10 mm burden; 4/63 pts underwent a new recanalization for uroenteric strictures in 3
neobladders and 1 ileal conduit; in 1/63 pt was performed a L.A.S.E.R. ablation of a small
superficial transitional cell carcinoma; in 1/63 pt was extracted a ureteral stent migrated to the
pelvis.
Results: For 57 nephrolithotripsy procedures stone- free rate was 98.3%; 1 patient needed stenting
for hydronephrosis and in 3 patients were positioned a monoJ catheter for haematuria for
some days, totally 7/63 pts were transfused (11%); the mean extimated blood loss was 0,65 ±
1,05 g/dL HB (range 0,1- 3,9 g/dL HB); for residual procedures (6 patients) there were no complications;
the mean hospital stay was 4,2 ± 2,8 days (range 2- 14 days).
Conclusions: The limits of this technique are: major operation times and consequently major
costs; more difficulties in vision and operability. The advantages are: less trauma, reduction of
bleeding, possibility of tubeless procedures and shorter recovery times. Supine position is certainly
a step forward in terms of reducing operative times and percentage of clearance of the
fragments. The progress mainly in optics and the miniaturization of instruments will make the
procedure more useful and effective.
KEY WORDS: Minipercutaneous procedure; Percutaneous nephrolithotripsy; MIPP-set; MINI-perc.
INTRODUCTION
Percutaneous nephrostomy procedures are generally
safe. The associated mortality rate is approximately
0,04% and the incidence of important complications is
about 5%. But, if we consider other aspects such as: hospitality
time, post-operative pain, patients with coagulation
diseases or renal abnormalities or transplanted kidney,
the minimal nephrostomy procedures are advisable.
We are presenting our instrumental set for mini-percutaneous
procedure (MIPP-set), manufactured in collaboration
with RÜSCH Medical Company, along with our
indications and clinical experience.
METHOD AND MATERIAL
We consider Minimal Percutaneous approach, a
nephrostomy tract equal or less than 14 Fr (inner diameter).
Our dilation set (MIPP PU/PVC by Frattini-
Cortellini) consists of : a 17,5 Gauge needle, a 0,035 inch
guide wire Lunderquist-type, 2 coaxial hydrophilic dilators
(9,14 Fr), a 14 Fr Amplatz sheath and a 12 Fr silicone-
coated nephrostomic catheter with metallic gauge
(Figure 1); the operative instruments should be a 11 Fr
Figure 1.
The MIPP set.
Archivio Italiano di Urologia e Andrologia 2007, 79, 3, Supplemento 1
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