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Double J Ureteral Stent are used for temporary internal drainage from the ureteropelvic junction to the bladder. Geotek Uretral Stents & DJ Stents have variations like; Closed tip/ Open tip, With or without Fissure, with or without Guidewire, Coated/ Uncoated. Material used is Poly-urethane mixed with Bismuth/ Barium to give Radio- nebulosity. Intended for one time use. Maximum indwelling time is one month. Ureteral stents are placed in to target towel over the companion line.

Double J Ureteral Stent Set

Soft polyurethane material Advanced kink resistance High radiopacity Depth marker Long pusher option between 40 cm-100 cm Fissure on distal tip Radiopaque pusher option Set includes DJ stent Pusher Guide line Two Clamps Features of an Optimal Double J Stent Placement Fashion Basic Principles Use the right length ureteral stent. While the length of the ureter can be estimated by CT, retrogradex-ray, or by the case's height, it's stylish to measure the ureteral length directly if possible. Nothing additional gives an accurate, dependable ureteral length dimension. The case's height can only give a vague approximation, and a typicalx-ray pyelogram will overrate the length by about 10 due tox-ray dissipation from the exaggeration effect between the case and the image intensifier. To gain an accurate ureteral length dimension, a 5 or 6 French open-concluded catheter is placed into the renal pelvis over a guidewire. A small quantum of adulterated discrepancy fitted retrograde into the open-concluded ureteral catheter is sufficient to fantasize the renalpelvis.However, it'll come grueling to see the retrograde catheter or the proximal end of the double J stent, so only a minimum quantum of adulterated discrepancy is used, If the renal pelvis becomes too opaque. The open-concluded catheter has fluently visible 1 cm markings, so the ureteral length (Uretero-Pelvic Junction to the ureteral perforation) is fluently measured. The proximal coiled end of the stent will always resettle to the most inferior position possible in the renal pelvis. This will extend the distal end of the double J further into the bladder where it may impact the contrary bladder wall causing fresh patient discomfort. For this reason, if the ureteral length measures an odd number of centimeters, elect a stent that matches the shorter length. There's sufficient length in the double J stent coils to fluently stretch the redundant centimeter without any detriment, discomfort, or migration threat. Choose a stent with the proper degree of severity. The stiffness or severity of the stent should be named grounded on the clinical situation. Further rigid stents are recommended in strictures, cancer cases, or when a gravestone can not be dislodged and must be bypassed by the stent. The redundant severity resists dropped drainage due to possible stent contraction, better than a stent from a softer material. Use the correct French size. The standard size for double J stents is generally 6 French. Larger periphery stents ( larger French sizes) are recommended when draining infections in obstructive pyelonephritis and pyonephrosis or for dilatingstrictures.However, consider using two lower French-sized stents in tandem, If a larger French size stent is asked but can not be placed. The proximal end of the stent should be completely curled and in the most inferior possible position in the renal pelvis. The secret is to allow the proximal end of the double J stent to coil completely, also move it into position while still leaving the guidewire incompletely inside the distal portion of the stent. Pressure on the dangler/ safety thread keeps the stent, pusher, and guidewire connected as a unit which allows for manipulation and indeed complete stent junking/ relief while leaving the guidewire in place for ureteral access. Getting the proximal end of the stent to coil in a small renal pelvis can be tricky. A initiative called the"Leslie Flip"is frequently helpful in similar situations. This involves renouncing the guidewire from the proximal end of the stent, also pulling the stent, line, and pusher back into the proximal ureter followed incontinently by sluggishly pushing all of them forward, back into the renal pelvis. The proximal stent tip, with its strong coiling memory, will try its stylish to make a completely indirect coil. This initiative can be repeated if necessary, to gain optimal results. (It's critical to have the dangler/ safety thread in place and under mild traction to be suitable to do this initiative. Else, the stent may not repudiate. This is one of the reasons we recommend leaving the dangler/ safety thread in place until the very end of the procedure.) Don't cut the dangler/ safety thread until the procedure is completed. As long as the dangler/ safety thread is attached to the distal end of the stent, it holds the stent and the pusher together while the guidewire remains in place between them, keeping them connected and aligned. This basically makes a single unit of these separate particulars which facilitates positioning and allows for the"Leslie Flip" initiative described preliminarily. Cutting the dangler/ safety thread at the morning of the case makes it nearly insolvable to change or indeed manipulate the stent without immolating the guidewire and conceivably losing access. In similar cases, it may be insolvable to recapture ureteral access, which can significantly complicate the case's clinical course. This is the single most helpful tip in double J stent placement and the most generally neglected. The dangler/ safety thread needs to be removed in a manner that won't move the stent out of position. The dangler thread can fluently be cut and removed at the end of the case as long as the pusher is still in place and the guidewire is always at least incompletely inside the distal end of the double J stent. The incompletely fitted companion line and pusher together stabilize the distal end of the stent and keeps everything adequately aligned with only gentle traction on the dangler thread. Without the thread, there's no way to keep the stent from moving during manipulation or to prize it without losing the guidewire and conceivably ureteral access as well. Once the thread is removed, the guidewire can be snappily withdrawn without dislodging the stent since the pusher will help distal migration of the stent and unintentional birth.