Characteristics of current digital single-use flexible ureteroscopes versus their reusable counterparts: an in-vitro comparative analysis

Dragoş, L.; Somani, Bhaskar K.; Keller, Etienne Xavier; Coninck, V.M.J. De; Herrero, María Rodríguez-Monsalve; Kamphuis, Guido; Bres-Niewada, Ewa; Şener, Emre; Doizi, Steeve; Wiseman, Oliver; Traxer, Olivier

doi:10.21037/tau.2019.09.17

Cited by 44 publications

(51 citation statements)

References 29 publications

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“…These phenomena may occur due to automatic light intensity regulation being affected by laser energy flashes or by stone fragments or dust that is flushed around by irrigation and laser pulse pressure waves. The cited in vitro comparison also demonstrated that the flow varied between different flexible ureteroscopes equipped with the same type of laser fibre [50]. The problem of working channel damage can be almost completely overcome by employing single-use flexible ureteroscopes.…”

Section: Endoscopes and Laser Lithotripsymentioning

confidence: 93%

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Consultation on kidney stones, Copenhagen 2019: aspects of intracorporeal lithotripsy in flexible ureterorenoscopy

et al. 2020

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Purpose To summarize current knowledge on intracorporeal laser lithotripsy in flexible ureterorenoscopy (fURS), regarding basics of laser lithotripsy, technical aspects, stone clearance, lithotripsy strategies, laser technologies, endoscopes, and safety. Methods A scoping review approach was applied to search literature in PubMed, EMBASE, and Web of Science. Consensus was reached through discussions at the Consultation on Kidney Stones held in September 2019 in Copenhagen, Denmark. Results and conclusions Lasers are widely used for lithotripsy during fURS. The Holmium laser is still the predominant technology, and specific settings for dusting and fragmenting have evolved, which has expanded the role of fURS in stone management. Pulse modulation can increase stone ablation efficacy, possibly by minimizing stone retropulsion. Thulium fibre laser was recently introduced, and this technology may improve laser lithotripsy efficiency. Small fibres give better irrigation, accessibility, and efficiency. To achieve optimal results, laser settings should be adjusted for the individual stone. There is no consensus whether the fragmentation and basketing strategy is preferable to the dusting strategy for increasing stone-free rate. On the contrary, different stone scenarios call for different lithotripsy approaches. Furthermore, for large stone burdens, all laser settings and lithotripsy strategies must be applied to achieve optimal results. Technology for removing dust from the kidney should be in focus in future research and development. Safety concerns about fURS laser lithotripsy include high intrarenal pressures and temperatures, and measures to reduce both those aspects must be taken to avoid complications. Technology to control these parameters should be targeted in further studies.

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Section: Endoscopes and Laser Lithotripsymentioning

confidence: 93%

“…In vitro comparison of single-use and reusable f lexible ureteroscopes showed that the latter had bettervision characteristics [50]. It appears that scopes differ regarding occurrence of light flashes during laser lithotripsy, over-illumination of the field, and the speed at which light intensity can be regulated.…”

Section: Endoscopes and Laser Lithotripsymentioning

confidence: 99%

Consultation on kidney stones, Copenhagen 2019: aspects of intracorporeal lithotripsy in flexible ureterorenoscopy

et al. 2020

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“…Measurements were performed with a protractor in 14/35 papers [6,10,12,[19][20][21][22]27,31,34,36,43,45,46]. Dragos et al [20], Johnson and Grasso [26], Tom et al [42] and Deininger et al [18] respectively used a ruler, a clockwork with degrees, SolidWorks angle measuring software and an Aristo goniometer to measure deflection.…”

Section: Deflectionmentioning

confidence: 99%

How to evaluate a flexible ureterorenoscope? Systematic mapping of existing evaluation methods

et al. 2021

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The objective of this study was to identify, map and review scope-related and user-related parameters used to evaluate the quality of flexible ureterorenoscopes. Thereby identifying key items and variability in grading systems. MethodsA literature search of four databases (MEDLINE [Ovid], EMBASE [Ovid], Web of Science, Google scholar and the Cochrane Library) was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines encompassing articles published up to August 2020. A total of 2386 articles were screened. ResultsA total of 48 articles were included in this systematic scoping review. All studies had a prospective design. Five key items in the assessment of flexible ureterorenoscopy were distinguished: 'Manoeuvrability' (87.5%), 'Optics' (64.6%), 'Irrigation' (56.3%), 'Handling' (39.6%) and 'Durability' (35.4%). After regrouping, every key item could be divided into specific subcategories. However, the quality assessment showed a wide variation in denomination, method of measurement, circumstances of measurement, tools used during measurements, number of measurements performed, number of observers, and units of outcomes. ConclusionThe research field regarding quality assessment of ureterorenoscopes is heterogeneous. In this systematic scoping review we identified five key parameters: Manoeuvrability, Optics, Irrigation, Handling and Durability, used to grade flexible ureterorenoscopes. However, within these categories we found a wide variety in terms of method of measurements. A standardised, uniform grading tool is required to assess and compare the quality of flexible ureterorenoscopes in the future.

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“…Single use scope are about 100 gms lighter that the digital scopes for instance a Uscope weighs 220gms – which is lesser than V2 or flex xc (which weigh around 325 gms). 23 , 24 Digital ureteroscopes are lighter in collation with their fiber-optic counterparts, as the latter tends to hold the additional weight of the camera head. The weight of currently available fiberoptic ureteroscopes varies: 309 to 352 g (mean 335 g) and 278 to 943 g (mean 700 g) for digital ureteroscopes but for fibro-optic ureteroscopes, another 266 to 798 g (mean 447 g) have to be added for the camera head.…”

Section: Type Of the Scopementioning

confidence: 99%

“…Regardless of the various types of scopes, it is ideally recommended to have more than one option of scopes. 24 With the continual technological advancement of single use ureteroscopes, the aforementioned factors can be utilized while customizing and designing right-sided and left-sided scopes in the future.…”

Section: Type Of the Scopementioning

confidence: 99%

Ergonomics and Surgeon Comfort During Flexible Ureteroscopy

Alnadhari¹,

Ali²,

Abdeljaleel³

et al. 2021

RRU

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The technological advancements of flexible ureteroscopy (FURS) and its accessories have resulted in broadening its indications to include the management of complex renal stones, with long operative time. The surgeon’s understanding about the ergonomics of the ureteroscopes and their cognizance of the operation theatre layout helps to improve their performance, including the surgical outcomes. This paper will describe the ergonomics that are involved in conducting FURS which in turn will aid in developing a more conducive surgical environment for the surgeon during the procedure, based on scientific literature review and expert opinions in high-volume centres. Proper surgeon position, well-arranged operation theatre layout, monitor and pedal position, anaesthesia type, and surgical team are important factors to decrease musculoskeletal strains for surgeons and increase work efficiency. Different types of flexible ureteroscope have different characters and knowing these special characters leads to better ergonomics during surgery. Robotic-assisted FURS have shown good safety and ergonomics in clinical application.

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Characteristics of current digital single-use flexible ureteroscopes versus their reusable counterparts: an in-vitro comparative analysis

Cited by 44 publications

References 29 publications

Consultation on kidney stones, Copenhagen 2019: aspects of intracorporeal lithotripsy in flexible ureterorenoscopy

Consultation on kidney stones, Copenhagen 2019: aspects of intracorporeal lithotripsy in flexible ureterorenoscopy

How to evaluate a flexible ureterorenoscope? Systematic mapping of existing evaluation methods

Ergonomics and Surgeon Comfort During Flexible Ureteroscopy

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