Improving the Durability of Digital Flexible Ureteroscopes

Cumulative Sum Analysis for Experiences of a Single-Session Retrograde Intrarenal Stone Surgery and Analysis of Predictors for Stone-Free Status

“…Previous studies reported increasing durability of flexible equipments, and recent investigations have shown that more than 100 procedures could be performed with one or two ureteroscopes with minimal damage to the equipment, depending on the level of care the instruments received [8], [18]. The surgeon in the present study performed all of the cases without any significant mechanical failure of the single flexible ureteroscope (Flex-X 2 ™), except for the perforations in the distal tip sheath.…”

“…Recently, some investigations demonstrated that RIRS can be a good management option for mid-sized stones between 1 to 4 cm [3], [10]. However, a steep learning curve and short-lived durability of flexible ureteroscopic equipment have disappointed surgeons who are uninitiated with the RIRS techniques [8].…”

“…Furthermore, RIRS can address the limitations associated with SWL such as lower-pole calyx stones, obesity, etc. However, the advantages of RIRS should not be overemphasized because of disadvantages such as short-lived durability of the flexible ureteroscopic equipment [8], possibility of staged procedures, or ureteral injury [9]. Few studies have reported cases in which RIRS was able to retrieve stones up to 3 cm in size, depending on the skill level of the operating surgeon [3], [10].…”

Comprehensive Costs Associated with Fiberoptic and Digital Flexible Ureteroscopes at a High Volume Teaching Hospital

“…Sharing similar concerns, Karaolides et al found that requiring trainees to demonstrate competency on a simulation model prior to live operative room experience, as well as application of several technical guidelines meant to preserve scope integrity, led to a decrease in repair rates from every 10.6 to 21.6 uses. 15 Furthermore, our standard technique for stone removal bears mention as it could contribute to our high rates of repair. We routinely remove all stone fragments meticulously via basket extraction rather than dusting with delayed passage.…”

The Effect of Repair Costs on the Profitability of a Ureteroscopy Program

“…3 Despite advances in technology and the use of techniques to minimize damage, multiple studies have reported that ureteroscope repair will be needed within 5 to 28 endoscope uses; the cost of these repairs has been reported to be in excess of $50,000 annually. [3][4][5][6][7][8] Nonetheless, as kidney stones affect approximately 10% of the population and claim an increasing prevalence, URS will likely continue to be an important component of surgical stone management. [9][10][11] What is less certain and particularly important in the present healthcare environment of cost containment, however, is how effectively a URS program can achieve a positive financial margin in light of these high overhead costs.…”