Background: The conventional percutaneous suprapubic cystostomy underdirect cystoscopy vision or ultrasound guidance remains a blind procedureassociated with high rate of complications (15-20%) and even mortality(0.5-1.8%). In order to define a precise localization of bladder and decreasemorbidity and mortality of procedure, a novel new surgical system T-SPeC?(Swan Valley Medical, Bigfork, MT) was developed. The device has beenapproved for use worldwide (Europe, Canada, Australia) and just recentlyin the United States. The T-SPeC? Surgical System is available in twomodels, T7 and T14, allowing large morbidly obese patients to be treated.We present the results of our first experience with this system used forintroducing a suprapubic catheter (18 Fr) via a retrourethral approach,with a 15 Fr. incision.Methods: Initially we evaluated a feasibility of the accurate insertion ofsuprapubic tube into the bladder using the T-SPeC? technique on 14human cadavers. Male and female cadavers were used with a BMI rangeof 28 to 43. In all cases, a precise suprapubic catheter placement wasachieved. Following this, 22 patients with a need for a suprapubic catheterplacement were selected. The T-SPeC? device was used under generalanesthesia to place a suprapubic catheter.Results: In cadaver study, there was no injury to adjacent organs found atautopsy after procedure was completed. In the live cases with the T-SPeCSurgical System, all patients had successful suprapubic tube placement. Nocomplications were encountered. The average surgical time of the procedureswas 9.4 minutes, with a range of 7.6-13.1 minutes. In all cadaver andlive clinical cases, accurate catheter placement into bladder was achieved.The estimated blood loss was negligible. All patients were discharged withinhours of the procedure.Conclusions: The novel T-SPeC Surgical System facilitates a faster, safer,and more precise suprapubic catheter placement than techniques currentlyavailable. This device is a useful addition to the urologic armamentariumfor patients requiring a suprapubic tube.
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机译：背景：常规经皮型胱天术术不足膀胱镜检查或超声波引导仍然是具有高并发症率高（15-20％）甚至死亡率（0.5-1.8％）的盲目的病程。为了定义膀胱精确定位和序列的降低和程序的死亡率，开发了一种新的新型手术系统T-SPET？（Swan Valley Medical，Bigfork，MT）。该器件已被批准在全球范围内（欧洲，加拿大，澳大利亚），宁愿美国。 t-spec？手术系统可在Twomodels，T7和T14中提供，允许大规模的病态肥胖患者进行治疗。我们通过转象方法向该系统提供了第一次经验的结果，其中通过刷新探测方法，有一个15 fr.切口。最初，我们使用T-SPEC评估了对武器管准确插入囊管的可行性吗？ 14多名尸体的技术。男女尸体与BMI系列28〜43一起使用。在所有情况下，一个精确的超自然导管置入静置。在此之后，选择了需要寄生电阻术的22例。 t-spec？装置在通风下使用，以放置一系列静脉导管。结果：在尸体研究中，在程序完成后，邻近器官没有伤害邻近的器官。在具有T-Specsurgical系统的实时病例中，所有患者都有成功的静物管放置。遇到了nocomplics。程序的平均手术时间9.4分钟，范围为7.6-13.1分钟。在所有Cadaver andlive临床病例中，实现了准确的导管放置到膀胱中。估计的血液损失可忽略不计。所有患者均在该过程中排出。结论：新型T-SPEM手术系统促进比目前可释力的技术更快，更安全，更精确的超自推导管展示。该装置是需要辅助管的泌尿感官的泌尿感官的有用补充。
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