Worldwide survey of flexible ureteroscopy practice: a survey from European Association of Urology sections of young academic urologists and uro-technology groups

Pietropaolo, Amelia; Bres-Niewada, Ewa; Skolarikos, Andreas; Liatsikos, Evangelos; Kallidonis, Panagiotis; Aboumarzouk, Omar; Tailly, Thomas; Proietti, Silvia; Traxer, O.; Giusti, Guido; Rukin, Nick; Özsoy, Mehmet; Talso, Michele; Emre, Sener Tarik; Emiliani, Esteban; Atış, Gökhan; Somani, Bhaskar K.

doi:10.5173/ceju.2019.0041

Cited by 16 publications

(4 citation statements)

References 23 publications

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“…The irrigation model has emerged as an in uential parameter of IRT. According to a survey study conducted among urologists interested in endourology in 2019, 46% preferred manual pump irrigation, and 27% preferred gravity irrigation as an irrigation method [23]. In this study, the highest mean IRT values were obtained in the gravity irrigation model compared to those in the other irrigation models, while the lowest mean IRT was obtained in the manual irrigation model (Table 3).…”

Section: Discussionmentioning

confidence: 58%

Monitoring Intrarenal Temperature Changes During Ho:YAG Laser Lithotripsy in Patients Undergoing Retrograde Intrarenal Surgery: A Novel Clinical Study

Kose,

Bostanci,

Gulsen

et al. 2024

Preprint

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Ho:YAG laser lithotripsy is a widely used technique for treating urinary stones, but concerns persist regarding its thermal effects on renal tissues. This study aimed to monitor intrarenal temperature changes during kidney stone treatment using retrograde intrarenal surgery with Ho:YAG laser. Fifteen patients were enrolled. Various laser power settings (0.8 J/10 Hz, 1.2 J/12 Hz) and irrigation modes (10 cc/min, 15 cc/min, 20 cc/min, gravity irrigation, and manual pump irrigation) were used. Temperature changes were recorded with a T-type thermal probe with ± 0.1°C accuracy. The laser power had the most significant effect on the mean temperature, with the mean temperature being 4.981°C higher for the 14 W laser power than for the 8 W laser power (p < 0.001). The mean temperature was 2.075°C higher in the gravity irrigation model and 2.828°C lower in the manual pump irrigation model (p = 0.038 and p = 0.005, respectively). Body mass index, laser power, irrigation model and operator duty cycle explained approximately 49.5% of the mean temperature (Adj. R2 = 0.495). Results revealed that laser power and operator duty cycle positively impacted mean temperature, suggesting that higher settings and longer activation periods led to increased temperature. Conversely, increases in body mass index and utilization of certain irrigation models were associated with decreased mean temperature. Laser power and irrigation rate are critical determinants of intrarenal temperature during Ho:YAG laser lithotripsy. Optimal settings and irrigation strategies are essential for minimizing thermal injury risk. This study highlights the importance of ongoing research to better understand and mitigate thermal effects during laser lithotripsy.

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Section: Discussionmentioning

confidence: 58%

Monitoring Intrarenal Temperature Changes During Ho:YAG Laser Lithotripsy in Patients Undergoing Retrograde Intrarenal Surgery: A Novel Clinical Study

Kose,

Bostanci,

Gulsen

et al. 2024

Preprint

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“…Our study is not the first to explore su-fURS utilization amongst urologists. A survey completed by 114 members of the European Association of Urology young academic urologists and uro-technology groups in 2022 found that only 2.7% of respondents used su-fURS more than 80% of the time, with 59.4% not using su-fURS at all ( 12 ). In addition to showing progression of su-fURS utilization in this more contemporary survey, we are the first to explore reservations urologists may have to adopting the technology.…”

Section: Discussionmentioning

confidence: 99%

Single-use flexible ureteroscopes: practice patterns, attitudes, and preferences for next-generation concepts

Salka,

Bahaee,

DiBianco

et al. 2024

Front. Surg.

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BackgroundSingle use flexible ureteroscopes (su-fURS) have emerged as an alternative to reusable flexible ureteroscopes (r-fURS) for the management of upper urinary tract calculi. However, little is known about urologist usage and attitudes about this technology. Through a worldwide survey of endourologists, we assessed practice patterns and preferences for su-fURS.MethodsAn online questionnaire was sent to Endourology Society members in January 2021. The survey explored current su-fURS practice patterns, reasons for/against adoption, and preferences for next generation models including developments in imaging, intra-renal pressure, heat generation, and suction. Responses were collected through QualtricsXM over a 1-month period from surgeons in North America, Latin America, Europe, Asia, Africa, and Oceania. The study was conducted according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES).Results208 (13.9%) members responded to the survey. Most respondents (53.8%) performed >100 ureteroscopies per year. 77.9% of all respondents used su-fURS for less than half of all procedures while only 2.4% used su-fURS for every procedure. 26.0% had never used a su-fURS. Overall, usage was not influenced by a surgeon's geographic region, practice environment, or years of experience. Top reasons for not adopting su-fURS were cost (59.1%) and environmental impact (12.5%). The most desired improvements in design were smaller outer shaft size (19.4%), improved optics and vision (15.9%), and wireless connectivity (13.6%). For next generation concepts, the functions most commonly described as essential or important by respondents was the ability to suction fragments (94.3%) while the function most commonly noted as not important or unnecessary was incorporation of a temperature sensor (40.4%).Conclusionssu-fURS are not commonly used, even among urologists who perform a high number of fURS. The primary concern for adoption is cost and environmental impact. Suction capability was considered the most important future development.

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“…Third, only one laser setting, 0.4 J/60 Hz, was used in the current study. The dusting technique, which has become a popular technique in RIRS, uses high-power laser settings and requires a low pulse energy of 0.2–0.5 J and a high frequency of 2–80 Hz [ 14 , 15 ]. The laser settings available for both laser systems were limited; thus, this laser setting was used.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Changes in Fluid Temperatures during Laser Irradiation Using Various Laser Modes: A Thermography-Based In Vitro Phantom Study

Yamashita

Inoue

Imai³

et al. 2023

JCM

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The differences in dynamic thermal changes during laser lithotripsy between various laser pulse modes are unclear. We used thermography to evaluate the temporal changes in high-temperature areas during laser activation in order to compare different laser pulse modes. An unroofed artificial kidney model was used for the experiments. The laser fired for 60 s with a laser setting of 0.4 J/60 Hz in the following four different laser pulse modes without saline irrigation: short pulse mode (SPM), long pulse mode (LPM), virtual basket mode (VBM) and Moses mode (MM). Using the first 30 s of moving images, we compared the ratio of a high-temperature area of >43 °C to the total area every 5 seconds. The dynamic changes in fluid temperatures were shown to be different between the laser pulse modes. The extent of the high-temperature areas during the laser activation was large in the LPM and MM compared with the SPM and VBM. While the high-temperature areas expanded in an anterior direction in the early laser irradiation period using the LPM, they spread in a posterior direction in the early laser activation period using the MM. Although only the temperature profile in one specific plane was investigated, these results are considered useful for preventing thermal injuries during retrograde intrarenal surgeries.

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Worldwide survey of flexible ureteroscopy practice: a survey from European Association of Urology sections of young academic urologists and uro-technology groups

Cited by 16 publications

References 23 publications

Monitoring Intrarenal Temperature Changes During Ho:YAG Laser Lithotripsy in Patients Undergoing Retrograde Intrarenal Surgery: A Novel Clinical Study

Monitoring Intrarenal Temperature Changes During Ho:YAG Laser Lithotripsy in Patients Undergoing Retrograde Intrarenal Surgery: A Novel Clinical Study

Single-use flexible ureteroscopes: practice patterns, attitudes, and preferences for next-generation concepts

Dynamic Changes in Fluid Temperatures during Laser Irradiation Using Various Laser Modes: A Thermography-Based In Vitro Phantom Study

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