Seth K. Bechis, MD, presented “Emerging Topics in Ureteroscopy: Pressure, Temperature, and Suction” during the 43rd Annual Ralph E. Hopkins Urology Seminar on January 31, 2024, in Jackson Hole, Wyoming.
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How to cite: Bechis, Seth K. “Emerging Topics in Ureteroscopy: Pressure, Temperature, and Suction” January 31, 2024. Accessed Jul 2024. https://grandroundsinurology.com/emerging-topics-in-ureteroscopy-pressure-temperature-and-suction/
Emerging Topics in Ureteroscopy: Pressure, Temperature, and Suction – Summary
Seth K. Bechis, MD, discusses methods to reduce pain, sepsis, and other complications in the use of ureteroscopy to treat renal conditions. He begins by examining the relationship between intrarenal pressure (IRP), pain, and infection. He discusses the importance of monitoring IRP during ureteroscopy and explores methods of reducing IRP, including irrigation control.
Dr. Bechis then discusses the issue of thermal injury in ureteroscopy. He illustrates the benefits of proper irrigation, shorter laser pedal activation time, and laser setting in preventing the denaturation of proteins in the kidney. He compares the temperatures generated by Holmium and TFL lasers, noting that TFL is a higher-energy option.
Dr. Bechis concludes by examining the role of suction in renal stone removal. He presents a demonstration of various suction devices and discusses their strengths and limitations. He warns that the use of a suction device lengthens the duration of the procedure and that suction still has room for improvement as a treatment.
About The 43rd Annual Ralph E. Hopkins Urology Seminar:
The Ralph E. Hopkins Urology Seminar is a multi-day meeting focused on training urologists in the latest in assessing, diagnosing, and treating urologic conditions in the clinical setting. Updates are provided on urologic cancers, stone disease, urologic reconstruction, female urology, infertility, sexual function, emerging surgical techniques, and general urology. The 43rd iteration of the meeting took place from January 31st to February 2nd, 2024, in Jackson Hole, Wyoming.
For further educational activities from this conference, visit our collection page.
ABOUT THE AUTHOR
Seth K. Bechis, MD is a board-certified urologist specializing in diseases of the urinary tract, including kidney stones, benign prostatic hyperplasia (BPH) or enlarged prostate, and men's health issues. Dr. Bechis completed fellowship training in laparoscopy/robotics and endourology at the University of California (UC), San Diego School of Medicine, and residency training at Harvard Medical School, Massachusetts General Hospital in Boston. He earned his medical degree from UC San Francisco School of Medicine and holds additional Master of Science training in biomedical research, also from UC San Francisco, focusing on ways to prevent and treat diseases.
As a member of the Comprehensive Kidney Stone Center at UC San Diego Health, Dr. Bechis has a special interest in advanced surgical treatment, medical prevention, and research on kidney stone disease. He has surgical expertise in percutaneous nephrolithotomy (PCNL) for complex stones, ureteroscopy, and shockwave lithotripsy. Dr. Bechis specializes in all procedures of the prostate including minimally invasive procedures such as Rezum water vapor therapy and UroLift, as well as robotic surgery and GreenLight™ Laser photoselective vaporization of the prostate (PVP).
Dr. Bechis serves as the associate program director for the UC San Diego - Kaiser Laparoscopy/Endourology Fellowship in the Department of Urology at UC San Diego School of Medicine. His current research includes improving surgical techniques and clinical outcomes in stone disease, as well as tools for stone diagnosis and opiate-sparing pathways for managing pain. His research has been featured in peer-reviewed medical journals and he has authored chapters for university handbooks.
Prior to joining UC San Diego Health, Dr. Bechis worked at Massachusetts General Hospital and Harvard Medical School, where he taught residents and medical students in the operating room and clinic.