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A New Boom for Cystoscopic Procedures
THE JOURNAL OF UROLOGY
Vol. 82, No. 1, .July 1959 Printed frl U.S.A.
A l\EW BOO::\J FOR CYSTOSCOPIC PROCEDuRES ivIORETON A. :MAGID
Nothing is more exasperating than the entanglement that occurs in the cords and water tubing while doing endoscopic procedures, particularly so during transurethral surgery when the instrument is disengaged from its sheath on innumerable occasions. ·without a doubt, the ire and impatience which are manifested when one cord is too short or the light connections pull free have caused many an operator to lose temper which may be reflected in the quality of his work. As has been mentioned, the difficulties which have arisen as a result of cord and tubing being too long or too short stimulated the author to look for a better means of controlling these of equipment. A. trial with the elements suspended by grouped rubber bands suspended above the patient's pubic area worked fairly well but never were they evenly balanced. If all elements were of equal length then, when the 1rnrking element of the resectoscope was completely removed, the light cord was too short. -When left long enough for the maneuver, then it dropped over the eye piece or was in the way of the working element. A review of the arm., which 1rns designed for the purpose of carrying the water, light and radio frequency cords, revealed it to be lacking in flexibility. Due to the ability of the light cord to pick up radio frequency energy, it should not be in too c:lose proximity to the radio frequency cord from the surgical unit. The cystoscope bulb will brighten when the radio frequency unit is energized and burn out if the absorption is too great. Therefore, the light cord should not run in metal tubing. The cord from t}ic; elec:trosurgical unit should not be encased in the metal tubing because the tapacity effect would be great enough, at the high frequency generated, that the current would be by-passed to the ground and, in turn, there would be lack of cutting or coagulation. In trying to devise a 1ncans of controlling the extra cystoscopic: elements, it was felt that some sort of boom would be the most practical. Sev8ral different types were investigated. All
were adjustable but unfortunately, a.fter adjusted, were fixed in position and did not ha.vr, mobility which cystoscopic procedures necn,,sitated. A microphone boom which is maimfactured commercially was procured. Thi~ particular equipment is n:1ounted on a C and swivels freely on a central axis. The 1·emainder of the boom is made up of a double frame which is spring-loaded so that it m.ait:tains its position and may be changed to any new position with the slightest pressure. The tubing and cord-holding mechanism wt,re made from a one foot piece of aluminum with eyes to hold plastic clothes pins. As may be seen from the illustrations, the elements are well colltrolled. In usage, the boom is clnmpecl to the film tray of the cystoscopic table. After the is prepared, the sterile clothes pins are on their individual hook-eyes and the e.nrdr; then clamped one foot from their ends. .After the cords are attached to the resectoscope, the boom is raised to extend the cords. Aftc:r the boom is set to have the sliglikst loading. The boom follows the opcrntoi'
Fm. l
Accepted for publication October 20, 1958. 171
172
MORETON A. MAGID
FIG. 2
the resection, swinging outwardly when the resectoscope is removed, towards the patient's head as it is replaced. The boom raises and lowers with the slightest pull on the cords so that the operator does not realize he is doing it and the cords and tubing are always out of the
way. This is particularly true when the instrument is rotated, because the instrument works through an arc of 360 degrees and the cords can be a real nuisance at these times. 1525 Colcord Ave., Waco, Texas
Vol. 82, No. 1, .July 1959 Printed frl U.S.A.
A l\EW BOO::\J FOR CYSTOSCOPIC PROCEDuRES ivIORETON A. :MAGID
Nothing is more exasperating than the entanglement that occurs in the cords and water tubing while doing endoscopic procedures, particularly so during transurethral surgery when the instrument is disengaged from its sheath on innumerable occasions. ·without a doubt, the ire and impatience which are manifested when one cord is too short or the light connections pull free have caused many an operator to lose temper which may be reflected in the quality of his work. As has been mentioned, the difficulties which have arisen as a result of cord and tubing being too long or too short stimulated the author to look for a better means of controlling these of equipment. A. trial with the elements suspended by grouped rubber bands suspended above the patient's pubic area worked fairly well but never were they evenly balanced. If all elements were of equal length then, when the 1rnrking element of the resectoscope was completely removed, the light cord was too short. -When left long enough for the maneuver, then it dropped over the eye piece or was in the way of the working element. A review of the arm., which 1rns designed for the purpose of carrying the water, light and radio frequency cords, revealed it to be lacking in flexibility. Due to the ability of the light cord to pick up radio frequency energy, it should not be in too c:lose proximity to the radio frequency cord from the surgical unit. The cystoscope bulb will brighten when the radio frequency unit is energized and burn out if the absorption is too great. Therefore, the light cord should not run in metal tubing. The cord from t}ic; elec:trosurgical unit should not be encased in the metal tubing because the tapacity effect would be great enough, at the high frequency generated, that the current would be by-passed to the ground and, in turn, there would be lack of cutting or coagulation. In trying to devise a 1ncans of controlling the extra cystoscopic: elements, it was felt that some sort of boom would be the most practical. Sev8ral different types were investigated. All
were adjustable but unfortunately, a.fter adjusted, were fixed in position and did not ha.vr, mobility which cystoscopic procedures necn,,sitated. A microphone boom which is maimfactured commercially was procured. Thi~ particular equipment is n:1ounted on a C and swivels freely on a central axis. The 1·emainder of the boom is made up of a double frame which is spring-loaded so that it m.ait:tains its position and may be changed to any new position with the slightest pressure. The tubing and cord-holding mechanism wt,re made from a one foot piece of aluminum with eyes to hold plastic clothes pins. As may be seen from the illustrations, the elements are well colltrolled. In usage, the boom is clnmpecl to the film tray of the cystoscopic table. After the is prepared, the sterile clothes pins are on their individual hook-eyes and the e.nrdr; then clamped one foot from their ends. .After the cords are attached to the resectoscope, the boom is raised to extend the cords. Aftc:r the boom is set to have the sliglikst loading. The boom follows the opcrntoi'
Fm. l
Accepted for publication October 20, 1958. 171
172
MORETON A. MAGID
FIG. 2
the resection, swinging outwardly when the resectoscope is removed, towards the patient's head as it is replaced. The boom raises and lowers with the slightest pull on the cords so that the operator does not realize he is doing it and the cords and tubing are always out of the
way. This is particularly true when the instrument is rotated, because the instrument works through an arc of 360 degrees and the cords can be a real nuisance at these times. 1525 Colcord Ave., Waco, Texas