The Evolution and Development of the Bladder Evacuator
BAUS ePoster online library. Sibartie T. Jun 25, 2019; 259557; P6-3
Ms. Tara Sibartie
Ms. Tara Sibartie
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In 1824, Civiale performed the first lithotrity. Despite taking minutes subsequent sessions were required to remove the fragments. Peers became content to let patients void the debris, but it was apparent that not all fragments passed and the residue served as nidus for new stones. Heurteloup(1793-1864) proposed that all debris should be removed at the primary procedure, but syringe irrigation through a metal-catheter proved insufficient.

In 1846, Crampton developed his aspirator; a water-filled glass-reservoir attached to an evacuating-catheter. The Clover aspirator(1865) followed, featuring a glass-reservoir attached to an India-rubber bulb. However, for both efficacy was poor.

With the widespread introduction of Ether anesthesia and knowledge on urethral calibre(Otis;1825-1900) Bigelow introduced his 'litholapaxy' procedure(1876); stone crushing with immediate fragment evacuation in one sitting. The evacuator featured a large-calibre catheter attached to an India-rubber bulb with glass trap beneath to catch the fragments.

Attention then focussed on techniques to prevent aspirated debris returning to the bladder. Thompson placed an internal-valve between the evacuating-catheter and glass receiver(1884). Whilst Freyer, like Bigelow, placed a glass-reservoir beneath the Indian-rubber bulb(1885).

Evolution then stagnated until Alcock entrusted his resident with the task of improving the evacuator so that it was compatible with cystoscopes and could safely extract prostate chippings, tumour and clot. Ellik developed the familiar hour-glass reservoir with red-rubber bulb(1937) which remained a mainstay until the 1990s.

Single-use plastic evacuators then emerged with flap-valves and filters to permit more efficient evacuation. These developments cemented the bladder evacuator as an essential component of the endourologist's armamentarium.
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