Acucise endopyelotomy: evolution of a less-invasive technology.

Since its introduction in 1993, the electrosurgical cutting balloon device (Acucise) has been utilized for endopyelotomies by a number of investigators. The fact that the procedure can be performed in a completely retrograde fashion under fluoroscopic guidance without percutaneous access has made Acucise endopyelotomy appealing to many urologists. To date, overall Acucise endopyelotomy success rates ranging from 66% to 84% have been reported. The average hospital stay has ranged from 1.7 to 3.7 days, and serious complications have been rare (transfusion 0-2%, bleeding necessitating embolization 0-3%). On the basis of its track record and its minimally invasive nature, a compelling argument can be made for use of the Acucise device whenever an endopyelotomy is indicated.