STENT REMOVAL

ANTIBIOTIC
Inj gentamycin 80mg
Anaesthesia
Under local anaesthesia (2%xylocaine jelly)
Position
The patient is positioned in a comfortable lithotomy position
Skin preparation
The skin is usually cleaned with a antimicrobial solution (eg. Betadine solution)
In women
Begin from the umbilical region, covering the pubic area, the inner thighs, the vaginal vault, cefrvix, perineum and anus.
In men
Begin from the umbilical region, covering the pubic area, the inner thighs, the scrotum and anus

Draping
1 small drape under the buttocks
2 leggings, one for each leg
1 small drape sheet over the abdomen
Instruments
Cystoscopy sheath with obturator (17fr/20fr/22fr)
Telescope 0 degree / 30 degree
Bridge
Light source cable
Endo camera
Biopsy forceps
Miscellaneous things
2%xylocaine jelly
Disposable syringe 10ml
I.V set
Normal saline 1 L bottle
Procedure
Apply 2%xylocaine jelly per urethrally
Take the cystoscopy sheath and make the following connections.
1.connect bridge to cystoscopy sheath
2.insert 0 degree telescope inside the cystoscopy sheath
3.connect Endo camera to the telescope
4.connect light source to the cystoscopy sheath
5.connect the irrigation source

After all connections have been made, check to see if all channels are closed (cystoscopy sheath and bridge)
Introduce the cystoscopy sheath per-urethrally after opening the irrigation channel
The bladder is filled with irrigation fluid, under direct vision, the urethra the bladder neck and the ureteric orifices are examined
Next remove the cystoscope obturator and introduce the biopsy forceps and under direct vision grasp the end of the ureteric stent
Gently remove the grasper along with the stent, to avoid injury to the ureter
At the end of the procedure the bladder should be emptied and the cystoscope sheath removed.