Novel semirigid ureterorenoscope with irrigation and vacuum suction system: introduction and initial experience for management of upper urinary calculi

Abstract

Objective: This study aims to design a novel semirigid ureterorenoscope with irrigation and vacuum suction system and a modified ureteral access sheath (UAS) named Sotn ureterorenoscope ® (Sotn=ShuoTong Medical Company) to overcome the deficiencies of the current procedure and to improve the efficiency and safety of using Sotn ureterorenoscope ® for treatment of upper urinary calculi. Materials and Methods: Fifty-eight patients, comprising 31 males and 27 females, were evaluated. The medical records of 58 patients with upper urinary calculi treated with Sotn ureterorenoscope ® from March 2015 to June 2017 were retrospectively reviewed at the Second Affiliate Hospital of Guangzhou University of Chinese Medicine in China. The primary outcome was stone-free rate (SFR) assessed by computed tomography on the 1st day and one month after treatment. The secondary outcome was postoperative complication rate. Results: The mean and SD of operative duration was 48.5 (10.4) min, and the mean and SD of stone size was 15.6 (5.6) mm. The primary overall SFR was 89.7% (52/58) and 100% at 1 month follow-up. Complication, which was Clavien I (minor fever managed by antipyretic therapy), was detected in 1.7% (1/58) of the patients. Conclusions: Sotn ureterorenoscope ® is technically feasible, efficacious and safe for treatment of upper urinary calculi because of its advantages of high SFR and low complication rates.

Comparison of the Efficacy of ShuoTong Ureteroscopy and Simple Flexible Ureteroscopy in the Treatment of Unilateral Upper Ureteral Calculi

“…In this study, three patients in the F-URS group had postoperative hematuria while there were no patients with postoperative hematuria or postoperative ureteral injury in the ST-URS group. Consistent with our results, there were no complications of the ureteral mucosa stripping, perforations, and avulsions founded in other studies ( 33 , 39 , 40 ). A study showed that high-power laser lithotripsy settings fired in long bursts with low irrigation flow rates can generate high fluid temperatures in the process of holmium laser lithotripsy ( 41 ).…”

“…This may be related to the small sample size in this study and the results need to be confirmed by a large sample study in the future. Our study combined with these published results showed that the ST-URS with negative pressure suction device has the advantages of high lithotripsy efficacy, fewer complications, more safety, and treating the upper ureteral calculi effectively (33,35,39,40). Ito et al reported that the CT value of stones is significantly related to the efficiency of lithotripsy (42).…”

“…Recently, ST-URS, a new lithotripsy operation method in China is widely used in the treatment of ureteral stones. During the operation, the surgeon can adjust the rotary knob to control the negative pressure and actively control the pressure of the suction of stones for simultaneous reduction of the renal pelvic pressure and active suction of the stones ( 33 ). Therefore, ST-URS can bring the following surgical effects: 1) at the same time as lithotripsy, the broken stone particles and powder are directly sucked out through the ureteral inlet sheath, thus realizing the integration of crushing and removing stones.…”

“…ST-URS adopts an adjustable negative pressure suction device, the surgeon can actively control the size of the attraction, maintain the low pressure of the renal pelvis, thus significantly decrease perioperative infectious complications ( 39 , 40 ). Instead of F-URS, the ST-URS is placed under direct vision, which may reduce the damage of the ureter during the insertion process ( 33 ). In this study, three patients in the F-URS group had postoperative hematuria while there were no patients with postoperative hematuria or postoperative ureteral injury in the ST-URS group.…”

Comparison of vacuum suction semirigid ureteroscopic laser lithotripsy and flexible ureteroscopic laser lithotripsy for upper ureteral calculi with a diameter ≥ 15mm: a retrospective study

“…Exceeding 3.99 kPa (30 mmHg) [28] of renal pelvic pressure can cause various types of renal damage, including uid re ux or extravasation, infection spread, urinary sepsis, and infectious shock [29] . The Sotn-URS group's postoperative fever rate in our current study was 2.08%, which is similar to the 1.7% reported by Gan et al [30] . Furthermore, Wu [31] et al's study discovered that the novel vacuum suction ureteroscopic laser lithotripsy(VS-URS) group's fever rate was noticeably lower than that of the traditional ureteroscopic laser lithotripsy (T-URS) group.…”