Initial Experience with Novel Single-Use Disposable Ureteroscopy: A Prospective, Single Arm 90-Day Trial of the Axis Ureteroscope

Abstract

Introduction: Novel digital disposable ureteroscopes are becoming more commonplace in endourological practices. We trialed the AxisÔ single-use ureteroscope, which is distributed within the United States by Dornier MedTech. Our goal was to demonstrate clinical equivalence to our reusable platform and to evaluate the cost-effectiveness of a single-use digital ureteroscope.Methods: We conducted a prospective 90-day trial where all flexible ureteroscopic procedures were completed using the single-use ureteroscope. The cases were monitored for scope failure, scope deficiencies and surgeon satisfaction scores via an immediate postoperative REDCapÒ survey. We also performed a cost analysis between reusable scopes and the single-use ureteroscope. The cost of the reusable platform included the amortized initial purchase, maintenance and clean processing.Results: Over a 90-day period, we performed 93 flexible ureteroscopy procedures with a single-use ureteroscope, of which 74 were completed using Axis. After controlling for operating room time and disposable items used, the utilization of Axis was associated with an average reduction of $140.31 per case. Extrapolating the per-case savings over an annual case volume, we estimate a total savings of $56,127.15. There were no disposable scope malfunctions. There were 4 (4.3%) cases converted to reusable scopes due to image quality (1), inadequate secondary deflection (2) and a tight ureter (1). MeanAESD score for image quality, mobility and ergonomics was 9.1AE1.1, 8.9AE1.1, 9.3AE1.1, respectively. The 90-day complication rates were equal to our controls. Conclusions:We demonstrated that the Axis single-use digital ureteroscope is equivalent in function to our digital reusable scope and reduced the cost of flexible ureteroscopy.

Market Readiness for Single-Use Cystoscopes According to Urologists and Procurement Managers Worldwide

“…Since then, single-use endoscopes have entered several endoscopy areas, including urology where single-use ureteroscopes are widely used today. With benefits such as cost-savings, 12 , 13 as well as elimination of the risk of cross-contamination and need for frequent repair, single-use ureteroscopes are now widely adopted, whereas single-use cystoscopes have only recently been introduced.…”

Initial Experience and Clinical Assessment of the Karl Storz FLEX-XC1 Single-Use Flexible Ureteroscope

“…8 We noted subjective equivalent image quality between reusable digital Storz FLEX-XC, SU Storz FLEX-XC1, and SU Dornier AXIS (Figure 2). Previous reports indicated that the AXIS was functionally equivalent to reusable digital ureteroscopes 13 and had higher image resolution and less image distortion than Lithovue, 14 while the SU PUSEN Uscope PU3022 was rated poor to fair for image quality and peripheral visual acuity. 15 In our evaluation, the FLEX-XC1 similarly demonstrated median postoperative upward and downward deflection of 270 , with only 1 device with 270 deflection before the procedure failing to maintain full range of deflection postoperatively.…”

“…We noted subjective equivalent image quality between reusable digital Storz FLEX-XC, SU Storz FLEX-XC1, and SU Dornier AXIS (Figure 2). Previous reports indicated that the AXIS was functionally equivalent to reusable digital ureteroscopes 13 and had higher image resolution and less image distortion than Lithovue, 14 while the SU PUSEN Uscope PU3022 was rated poor to fair for image quality and peripheral visual acuity. 15…”

Single-use flexible ureteroscope provides an alternative treatment for upper urinary calculi: A systematic review and meta-analysis

“…[30] For hospitals with high ureteroscope breakage rates, he advised these devices could serve as a valuable alternative, as well as immunocompromised patients who suffered infection risk can also be considered. A recent study by Large T [31] evaluated the technical characteristics of su-FURS, the score in su-FURS was high, with mean ± SD ratings of 9.1 ± 1.1, and 8.9 ± 1.1 for image quality and flexibility, respectively. Kam J [32] compared the efficacy of su-FURS and ru-FURS for upper urinary calculi.…”