Performance and Durability of Leading Flexible Ureteroscopes

User, Herbert M.; Hua, Vi N.; Blunt, Lynn W.; Wambi, Chris; Gonzalez, Christopher; Nadler, Robert B.

doi:10.1089/end.2004.18.735

Cited by 34 publications

(10 citation statements)

References 9 publications

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“…Main causes of flexible ureteroscope repair were represented by loss of deflection, perforation of inner lining by laser fiber, and breakdown of optical fibers. [567] In our series, ODF-URS (URF-V) was broken while approaching a lower calyx stone at an extremely acute infundibulo-pelvic angle. Several technical tricks and accessory instruments were presented during a number of studies aiming to prolong F-URS functionality.…”

Section: Discussionmentioning

confidence: 83%

“…They reported that between 10 and 34 procedures were performed before a malfunction requiring major repair occurred. [6] Considering that ODF-URS (URF-V) was used for 5430 min (90 h and 30 min) during 60 procedures with no need of repair, progresses in terms of durability seems to be obvious. Main causes of flexible ureteroscope repair were represented by loss of deflection, perforation of inner lining by laser fiber, and breakdown of optical fibers.…”

Section: Discussionmentioning

confidence: 99%

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The new Olympus digital flexible ureteroscope (URF-V): Initial experience

et al. 2011

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Objective:Flexible ureterorenoscopes (FURSs) are considered important additions to urology armamentarium. One of the technical drawbacks is the poor optic image provided by fiberoptic endoscope as well as the fragility of this conventional fiberoptic endoscope. This study aim is to evaluate practical performances and functional durability of the new Olympus digital flexible ureteroscope (ODF-URS) (URF-V) in a single center clinical setting.Materials and Methods:A number of 60 diagnostic and therapeutic procedures were performed over a period of 6 months in a single center (Tenon University Hospital), using a single ODF-URS (URF-V). This device provided a 275° maximal down-deflection (MDD) and 180° maximal up-deflection (MUD).Results:ODF-URS (URF-V) was used for a total time of 90 h and 30 min, with average time duration of 90.5 min per procedure. After 60 procedures, MDD decreased from 275° to 217°, while the MUD decreased from 180° to 161°. During six procedures (10%), URF-V failed to access inferior calyx due to a narrow lower calyx infundibulum.Conclusion:New ODF-URS (URF-V) is a reliable and durable device, with a good success rate and improved functional parameters. It is a superior device compared to predecessor generations of conventional fiberoptic endoscopes for the light source and the image quality; however, randomized comparative studies are necessary to evaluate performances and durability of this device.

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Section: Discussionmentioning

confidence: 83%

Section: Discussionmentioning

confidence: 99%

The new Olympus digital flexible ureteroscope (URF-V): Initial experience

et al. 2011

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“…The number of urologists using a single ureteroscope, experience of the endoscopist, location of the pathology, use of accessory instruments, duration of procedure and scope handling in between cases may all play a role in flexible ureteroscope trauma. [33] Historically, the number of procedures performed before a flexible ureteroscope requires repair averaged 6–15. However, by incorporating new ureteroscopic accessories, such as nitinol devices, a ureteral access sheath and the 200 µ holmium laser fiber into common practice, one can reduce the strain on fragile 7.5-F endoscopes, thereby maximizing their longevity.…”

Section: Durability Of Scopesmentioning

confidence: 99%

“…Channel perforation was directly attributable to damage by a laser fiber in all instances. [33] Hence care must always be exercised when advancing any laser fiber through the working channel, because these fibers are capable of penetrating the wall of instruments if passed while the scope is deflected. Therefore, straightening the tip of the ureteroscope will allow for easy passage of the laser fiber before manipulating the ureteroscope into the LC.…”

Section: Durability Of Scopesmentioning

confidence: 99%

Retrograde intrarenal surgery for lower pole renal calculi smaller than one centimeter

Shah

2008

Indian J Urol

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Objectives:Recently there has been an increasing interest in the application of retrograde intrarenal surgery (RIRS) for managing renal calculi. In this review we discuss its application for the management of lower calyceal (LC) stones less than 10 mm in maximum dimension.Materials and Methods:Literature was reviewed to summarize the technical development in flexible ureterorenoscopy and its accessories. Further, the indications, outcome and limitations of RIRS for LC calculi < 1 cm were reviewed.Results:Use of access sheath and displacement of LC stone to a more favorable location is increasingly employed during RIRS. Patients who are anticoagulated or obese; those with adverse stone composition and those with concomitant ureteral calculi are ideally suited for RIRS. It is used as a salvage therapy for shock wave lithotripsy (SWL) refractory calculi but with a lower success rate (46-62%). It is also increasingly being used as a primary modality for treating LC calculi, with a stone-free rate ranging from 50-90.9%. However, the criteria for defining stone-free status are not uniform in the literature. The impact of intrarenal anatomy on stone-free rates after RIRS is unclear; however, unfavorable lower calyceal anatomy may hamper the efficacy of the procedure. The durability of flexible ureteroscopes remains an important issue.Conclusions:RIRS continues to undergo significant advancements and is emerging as a first-line procedure for challenging stone cases. The treatment of choice for LC calculi < 1 cm depends on patient's preference and the individual surgeon's preference and level of expertise.

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“…1,2 There is a wide range in the rate of damage of fURSs and repair costs. [3][4][5] There are insufficient data about the proper distance between the laser fiber's tip and the scope to avoid instrumental damage caused by cavitation bubbles. We performed an observational study to evaluate the best position for the laser fiber to avoid fURS tip damage.…”

Section: Introductionmentioning

confidence: 99%