Ureteroscopy for Stone Treatment Using New 270° Semiflexible Endoscope: In Vitro, Ex Vivo, and Clinical Application

Abstract

The new ureterorenoscope facilitates retrograde stone management and might diminish repair intervals. Further development of comparable devices will support flexible ureterorenoscopy as a standard stone management procedure.

Working Tools in Flexible Ureterorenoscopy—Influence on Flow and Deflection: What Does Matter?

“…The success rate in these particular cases is almost 90%, quite superior to other literature data. 1 These results are emphasized by our study. Due to the technical developments in the flexible ureterorenoscopes but even more due to the development of thinner and more flexible stone baskets, the use of a basket does not cause a loss of deflection capacity.…”

“…Furthermore, a higher durability of the latest generation of ureterorenoscopes was shown. 1,2 However, many difficulties still remain concerning these ambitious goals, and quite a number of technical issues have been mentioned in literature. One problem is represented by the limited vision, related to the poor irrigation flow due to the partial obstruction of the irrigation channel by the work-BACH ET AL.…”

“…16 This new flexible ureteroscope seems to improve clinical and economic efficacy of retrograde stone management, with high in vivo durability and impressive deflection angles up to as much as 270 degrees with an empty working channel. 1 The DUR-8 Elite was studied by Ankem and associates in parallel with a conventional flexible ureterorenoscope. The latter failed to accomplish diagnostic or therapeutic upper urinary tract endoscopy in 28.9% of the cases.…”

Objective Assessment of Working Tool Impact on Irrigation Flow and Visibility in Flexible Ureterorenoscopes

“…The latest generation of fURS demonstrates improved durability and maneuverability. 1,5 Visibility is crucial in RIRS, however, and remains impaired in these devices, because of small caliber irrigation and working channels and subsequently a low volume of irrigation flow. Once working tools are introduced into the irrigation channel, irrigation flow decreases to a minimum or vanishes completely, depending on working tool size.…”

“…The latest generation of fURSs demonstrates improved durability and maneuverability. 1 Active deflection of 270 degrees and more is possible, and some fURS even offer an active or passive secondary deflection. 2 Visibility is crucial in endoscopy, however, and remains impaired in these devices, especially from diminished irrigation flow once working tools are introduced into the irrigation channel.…”