The new stent removing snare is designed to streamline indwelling ureteral stent removal in the office, with new access, increased convenience and minimal anesthesia. The design’s goal is ease of use and minimizing set-up time and patient discomfort by eliminating the cystoscopy. The 18 F snare is designed to work best in the male urethra. The snare should not be advanced beyond the bulbous urethra. The snare is also available in a smaller size 16 F, which works better removing a stent from the female bladder, as it may require more manipulation.
The Stent Removing Snare allows for the non-visual removal of indwelling ureteral stents, without the use of cystoscopy. The instrument is designed to be passed over a guide wire if clinically needed.
Method of Use
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Men – When the ureteral stent is inserted, the attached string should be left connected to the stent and a loop should be created in the string at the point where the string exits the urethra (see figure 1).
This loop will self-retract into the urethra, with a slight tug on the genitalia, where it comes to rest in the bulbous urethra or anterior urethra and it is not symptomatic. At time of removal, after the instillation of an urethral anesthetic lubricant, the snare is passed into a man’s urethra until the bulbous portion (see figure 2). Rotating the snare, the loop at the end of the string is hooked by the snare and then gently pulled out (see figure 3). Occasionally more than one pass is required. If multiple passes do not allow the snare to hook the string loop, it is possible that that the loop could have retracted into the bladder and cystoscopic removal is required. In men the snare should not be passed beyond the bulbous urethra.
Women – In women, the loop does not self-retract, but has to be pushed into the bladder with the scope or a well-lubricated hemostat. The hook of the snare enters the bladder and may grab the string or the stent itself (see figure 4). If the snare misses, repeat passes, or US supervision can be used to locate the stent. Cystoscopic removal is the fallback option.
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The snare is made of surgical steel, and has a flexible stem for tactile feedback in case of resistance during the course of its passage. There are no sharp edges on the snare to minimize discomfort during passage. It also has a central hole for passage over a guide wire.
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The design of the snare has a conical appearance with increasing size between 16-18 F. The snare element at the base of the cone is a groove 3 mm wide, which can hook the stent or the string attached to it. The design of the head allows for non-traumatic travel through the urethra. This conical configuration also allows this instrument to be used as a dilator, when passed over a guide wire, as a way to avoid a false passage with blind dilatation.
Removing a Stent with a Stent Removing Snare
How To Create A “Loop” In The String Attached To The Stent To Facilitate Stent Removal
Patient Having Stent Removed With A Stent Removing Snare
||Total Non Medicare National Facility RVUs2
||Medicare National Facility RVUs2 Allowed Amount2, 3
|50386 – Removal (via snare/ capture) of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation.
|50385 – Removal (via snare/ capture) and replacement of internally dwelling ureteral stent via transurethral approach, without use of cystoscopy, including radiological supervision and interpretation.
Uramix does not endorse any particular code for billing purposes. These codes are only provided for information purposes.
Description: 1 set (18F and 16F)
SKU #: 3301
Stent Removal Snare: $879 per snare, $1,399 for both