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

Abstract

Irrigation flow, loss of deflection, and intraoperative visualization are dependent on the working tool used. The provided data, in awareness of the patient's anatomy, help to select scopes, probes, and tools correctly for successful ureterorenoscopy.

What is the stone-free rate following flexible ureteroscopy for kidney stones?

“…Furthermore, introduction of a laser fibre results in a loss of deflecting ability of 10-15° which might result in failure to access stones in an acute lowerpole location. 56 The development of small calibre nitinol baskets to retrieve stones and relo cate them to a less dependent calyx, which enables laser lithotripsy and better postprocedural drainage, has helped address this limitation and improve the SFRs of patients with stones in the lower pole. …”

Early repeated ureteroscopy within 6–8 weeks after a primary endoscopic treatment in patients with upper tract urothelial cell carcinoma: preliminary findings

“…Interestingly, the recommendations regarding the follow-up schedule are mostly based on experts' opinions (grade C) [1] and rely mainly on the follow-up scheme of bladder cancer tumours. However, UTUC can be more difficult to be endoscopically identified and treated than bladder tumours, especially in the case of flat shape and/ or small size tumours, and when adequate endourological equipment is not available [27,28]. Moreover, since the tissue removed with an endoscopic biopsy might be poor and the tumour characteristics not available at final pathology [15,16], we hypothesized that performing an early second endoscopic evaluation could reduce the risk of local tumour progression in cases of initial understaging and/or undergrading of the disease and help assess the aggressiveness of the disease when histological evaluation is not reliable.…”

Effectiveness of Single Flexible Ureteroscopy for Multiple Renal Calculi

“…22 Even when up to 95% of stones can be removed with a single procedure, 23 multiple caliceal stones may necessitate multiple access tracts, which increase the risk of complications and discomfort. 24 Advances in flexible ureteroscopes, allowing detailed caliceal examination, and the introduction of Ho:YAG laser lithotripsy, allowing fragmentation of all stone types, even in dustlike particles, as well as the improvement in ureteroendoscopic instrumentation, such as nitinol stone baskets without interfering with the scope deflection grade, 25 have made ureteroscopy an alternative to SWL and PCNL for managing renal calculi. 3 Besides, fURS is useful in the management of stones in a caliceal diverticulum or in a horseshoe kidney, where stone-free rates with SWL are typically low because of poor fragment clearance.…”