Flexible Ureterorenoscopic Management of Lower-Pole Stone: Does the Scope Make the Difference?

Traxer, Olivier

doi:10.1089/end.2008.9792

Cited by 15 publications

(9 citation statements)

References 17 publications

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“…A good ureteroscope should have the following properties: good image quality, optimal maneuverability with full torque stability for easy access to the entire collecting system, adequate maximal deflection and irrigation flow when inserting a device into the working channel, and long durability. 16 …”

Section: Discussionmentioning

confidence: 99%

Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model

Proietti

Dragoş

Molina

et al. 2016

Journal of Endourology

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114

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Purpose: To evaluate LithoVue, the new single-use digital flexible ureteroscope, in a human cadaveric model and compare it with a nondisposable fiber optic and digital flexible ureteroscopes.Materials and Methods: LithoVue, a conventional fiber optic, and digital flexible ureteroscopes were each tested in four renal units of recently deceased female cadavers by three surgeons. The following parameters were analyzed: accessibility to the kidney and navigation of the entire collecting system with and without ureteral access sheath (UAS), lower pole access measuring the deflection of the ureteroscope with the working channel empty, and with inside two different baskets and laser fibers. A subjective evaluation of maneuverability and visibility was assessed by each surgeon at the end of every procedure.Results: Kidney access into the Renal unit 1 was not possible without UAS for all ureteroscopes because of noncompliant ureter at the level of sacroiliac joint. The reusable digital ureteroscope was unable to reach one calix of the lower pole and one calix of the upper pole (Renal units 2 and 3) without UAS placement. Lower pole access with baskets and laser fibers was possible for each ureteroscope after UAS placement. No statistically significant differences were detected in angle deflection between ureteroscopes. The digital ureteroscope was preferred for visibility in all procedures: LithoVue for maneuverability in six procedures, fiber optic in five procedures, and the digital ureteroscope in one procedure.Conclusions: LithoVue seems to be comparable with conventional ureteroscopes in terms of visibility and manipulation into the collecting system in fresh human cadavers. Further studies in humans are needed to determine the clinical value of this new instrument.

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Section: Discussionmentioning

confidence: 99%

Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model

Proietti

Dragoş

Molina

et al. 2016

Journal of Endourology

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114

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“…The use of UAS facilitates ureteral entry and re-entry [8,13], thus making flexible URS increasingly safe and feasible. In addition, technological advancement in modern flexible ureteroscopes allows the access to the entire pyelocaliceal system [14]. Finally, stone fragmentation with Holmium laser allows for high safety margins in urologic endoscopy under direct vision, even in patients on anticoagulation therapy [8].…”

Section: Discussionmentioning

confidence: 99%

Retrograde intrarenal surgery for the treatment of renal stones: is fluoroscopy-free technique achievable?

Peng

Zhang

et al. 2015

Urolithiasis

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The aim of this study was to present the safety and efficacy of retrograde intrarenal surgery (RIRS) procedures that minimize the intraoperative radiation exposure. The totally endoscopy-guided RIRS technique included the following steps: (a) preoperative assessment of pelvicaliceal system anatomy and stone characteristics, (b) thorough evaluation of the ureters by rigid ureteroscopy, (c) a step-wise approach of introducing the ureteral sheath, (d) gathering stones in the more accessible renal calyx before fragmenting them, and (e) a modified holmium laser technique. The RIRS procedures performed by a single surgeon between October 2012 and October 2013 in consecutive patients with renal stones were retrospectively reviewed. The mean stone size was 1.4 ± 0.4 (range 0.8-2.0) cm. The median operative time was 74.5 min. Fluoroscopy was only used in one patient who had a double collecting system with two ureters. The stone-free status was achieved in 134 (95.7%) patients one month after surgery. Five (3.6%) patients had minor complications, including hematuria and fever. No major intraoperative complication was observed. We believe that with appropriate preparation, RIRS without fluoroscopic guidance can be safely and efficiently performed by experienced urologists in selected patients with renal stones.

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“…DUR-D by Gyrus-ACMI has utilized the ''chip on the tip technology,'' resulting in better image quality. 7 Despite the ongoing improvements in technology, there is concern regarding the damages occurring due to handling of the costly endoscopes. Another area of concern is the need of sending the endoscope for repair, especially in countries with limited resources.…”

Section: Polyscope In Endourologymentioning

confidence: 99%

Polyscope: A New Era in Flexible Ureterorenoscopy

Bansal

Swain

Sharma

et al. 2011

Journal of Endourology

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Minimally invasive techniques are preferred for treatment of renal stones. The problem of lower caliceal stone access has been solved with the primary and secondary deflection of modern flexible ureteroscopes. The modular design of polyscope makes it a more cost-effective option. Relatively cheap and disposable multilumen catheters preclude the need for sterilization of optic cable, thus decreasing the chances of handling-related damages. The chance of instrument-related infection is minimal. Besides, it can be used as a semirigid ureteroscope should the need arises.

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Flexible Ureterorenoscopic Management of Lower-Pole Stone: Does the Scope Make the Difference?

Cited by 15 publications

References 17 publications

Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model

Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model

Retrograde intrarenal surgery for the treatment of renal stones: is fluoroscopy-free technique achievable?

Polyscope: A New Era in Flexible Ureterorenoscopy

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