ClearPetra Ureteral Access Sheath

Enough studies have showed the danger caused by high intra renal pressure during the lithotripsy. (30 mmHg is considered as the safety thresthold of intrarenal pressure. Oyelo-sinus,-tubular and venous backflow occurs when the Intrarenal pressure is above that. )

What if you could actively and easily control the IRP without compromising visual field, could evacuate stone fragments simply with suction and shorten the operation time?

A 45° oblique branch to the main sheath that can be connected to a suction apparatus

A pressure vent on the oblique to allow adjustment of suction pressure

Mechanism

The inflow of irrigation is through the endoscope.

The outflow of irrigation is between the scope and the sheath.

A vortex is created at the distal end of the sheath.

The irrigation fluid, the stone fragments, dust, and blood, etc. in the vortex can be aspirated out.

The aspiration pressure can be adjusted by the pressure vent on the oblique side branch of the sheath.

Family Overview

ClearPetra Ureteral Access Sheath

ClearPetra Nephrostomy Sheath

ClearPetra Cystoscope Sheath

ClearPetra Plus Ureteral Access Sheath

ClearPetra Plus Nephrostomy Sheath

ClearPetra Flexi Cystoscope Sheath

ClearPetra Steerable Access Sheath

ClearPetra MicroPerc Nephrostomy Sheath

Applications

ClearPetra Ureteral Access Sheath for RIRS

“Suction shapes the future of flexible ureteroscopy” – by various Urologists

Benefits

Maintaining Low lntra-luminal Pressure and Temperature

A vortex is created by the continuous irrigation and aspiration. The irrigated fluid can be effectively evacuated, thus always maintaining low intra-renal pressure and temperature, ensuring less complications and thermal damage.

High Stone Clearance Rate

The deflectable tip can be safely placed in the pyelo-calyceal system for better aspiration of the stone fragments even in the lower pole.

High Surgical Efficacy

Stone dust can be aspirated out during laser lithotripsy.

Reduced retropulsion

Stone fragments will aggregate at the distal end of the ClearPetra sheath instead of scattering.

Improving visual field

Under the continuous irrigation and suction, bleeding and dust storm from stone pulverization no longer obscure the visual field.

Treating Larger Stones

With the high efficacy, better vision, urologists cantreat larger stones.

Less Accessory Device Required

Stone basket, forceps, and anti-retropulsion device are no longer necessary as the stone fragments are aspirated out spontaneously.

ClearPetra Ureteral Access Sheath for RIRS(图1)

ClearPetra Ureteral Access Sheath for RIRS(图2)

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ClearPetra Ureteral Access Sheath for Semi-rigid Ureteroscopy

The only effective method for treating Steinstrasse

Benefits

High Stone Free Rate

The only effective method for Steinstrasse

ClearPetra Ureteral Access Sheath for Semi-rigid Ureteroscopy(图1)

ClearPetra Ureteral Access Sheath for Semi-rigid Ureteroscopy(图2)

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ClearPetra Nephrostomy Sheath

“There is some evidence of using suction during PNL to reduce intra-renal pressure and increase stone free rate.”
-EAU Guidelines 2022

Benefits

Total solution for PCNL and allows further miniaturization

Standard PCNL: > 24Fr

Mini PCNL (MIP): 16 – 22Fr

Supermini PCNL (SMP): 12 – 14Fr

Micromini (ClearPetra Micro): < 10Fr

(图1)

Conclusion

The ClearPetra Mini PCNL and MicroMini PCNL are as efficient as the Standard PCNL for treating bigger stones and maintaining intra-renal pressure, meanwhile they are safer with less bleeding and smaller wound area reduced by 62.3% with 16Fr Mini PCNL and 85.3% with 10Fr MicroMini PCNL.

Improves stone clearance

Reduces intrarenal pressure and temperature

Reduces stone scattering and antegrade migration

Increases efficacy and faster stone removal

Improve visualization

Reduce the need of stone basket or forceps

Cost saving for PCNL and hospitalization

ClearPetra Ureteral Access Sheath for RIRS(图1)

ClearPetra Nephrostomy Sheath(图2)

ClearPetra Nephrostomy Sheath(图3)

ClearPetra Nephrostomy Sheath(图4)

ClearPetra Nephrostomy Sheath(图5)

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ClearPetra Cystoscope Sheath

Making cystolitholapaxy less painful for the patients

Benefits

Improves surgical efficacy by aspirating stone fragments/tissue debris

Reduces bladder distention by efficient outflow

Improves patient comfort

ClearPetra Cystoscope Sheath(图1)

ClearPetra Cystoscope Sheath(图2)

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Stone Collection Bottle

Stone Collection Bottle(图1)

Stone Collection Bottle(图2)

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Literatures

EAU Guidelines. Edn. presented at the EAU Annual Congress Amsterdam, 2022. ISBN 978-94-92671-16-5.

Tzelves, L., et al. Suction Use During Endourological Procedures. Curr Urol Rep, 2020. 21: 46.

Pauchard F, Ventimiglia E, Corrales M, Traxer O. A Practical Guide for Intra-Renal Temperature and Pressure Management during Rirs: What Is the Evidence Telling Us. J Clin Med. 2022 Jun 15;11(12): 3429. doi: 10.3390/jcm11123429.

Hinman F, Redewill FH. Pyelovenous back flow[J]. JAMA, 1926,87:1287-1288.

Jung H U, Frimodt-Moller P C, Osther P J, et al. Pharmacological effect on pyeloureteric dynamics with a clinical perspective: a review of the literature[J]. Urol Res, 2006,34(6):341-350.

Wang D, Han Z, Bi Y, Ma G, Xu G, Hu Q, Xi H. Comparison of intrarenal pressure between convention and vacuum-assisted ureteral access sheath using an ex vivo porcine kidney model. World J Urol. 2022 Dec; 40(12):3055-3060. doi: 10.1007/s00345-022-04149-2. Epub 2022 Oct 8.

Guan W, Liang J, Wang D, Lin H, Xie S, Chen S, He J, Xu A. The effect of irrigation rate on intrarenal pressure in an ex vivo porcine kidney model-preliminary study with different flexible ureteroscopes and ureteral access sheaths. World J Urol. 2023 Feb 9. doi: 10.1007/s00345-023-04295-1. Epub ahead of print.

Reference Hospitals

USA. Cleveland Clinic
USA. UCSF
USA. Mount Sinai Healthcare System
UK. UCLH
France. Henri-Mondor University Hospital
Italy. UNIMI
Spain. Fundacio Puigvert
Sweden. Örebro University Hospital
Japan. 行徳総合病院

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