Digital ureteroscopes: technology update

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Abstract

The field of ureteroscopy has undergone a continual evolution since the first ureteroscopes were introduced. Over the past 10 years, we have entered into the digital era of ureteroscopy with both semirigid and flexible options becoming available. The following review looks at the benefits and drawbacks of digital flexible ureteroscopes as well as the current commercially available options.

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Most cited references 25

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Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model

Silvia Proietti, Laurian Dragos, Wilson Molina … (2016)

Abstract Purpose: To evaluate LithoVue, the new single-use digital flexible ureteroscope, in a human cadaveric model and compare it with a nondisposable fiber optic and digital flexible ureteroscopes. Materials and Methods: LithoVue, a conventional fiber optic, and digital flexible ureteroscopes were each tested in four renal units of recently deceased female cadavers by three surgeons. The following parameters were analyzed: accessibility to the kidney and navigation of the entire collecting system with and without ureteral access sheath (UAS), lower pole access measuring the deflection of the ureteroscope with the working channel empty, and with inside two different baskets and laser fibers. A subjective evaluation of maneuverability and visibility was assessed by each surgeon at the end of every procedure. Results: Kidney access into the Renal unit 1 was not possible without UAS for all ureteroscopes because of noncompliant ureter at the level of sacroiliac joint. The reusable digital ureteroscope was unable to reach one calix of the lower pole and one calix of the upper pole (Renal units 2 and 3) without UAS placement. Lower pole access with baskets and laser fibers was possible for each ureteroscope after UAS placement. No statistically significant differences were detected in angle deflection between ureteroscopes. The digital ureteroscope was preferred for visibility in all procedures: LithoVue for maneuverability in six procedures, fiber optic in five procedures, and the digital ureteroscope in one procedure. Conclusions: LithoVue seems to be comparable with conventional ureteroscopes in terms of visibility and manipulation into the collecting system in fresh human cadavers. Further studies in humans are needed to determine the clinical value of this new instrument.

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A new robot for flexible ureteroscopy: development and early clinical results (IDEAL stage 1-2b).

Remzi Saglam, Ahmet Yaser Muslumanoglu, Zafer Tokatli … (2014)

An improved armamentarium has had a significant impact on the emerging role of flexible ureteroscopy (FURS) for the management of nephrolithiasis; however, FURS still represents a challenging technique.

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Flexible ureteroscopes: a single center evaluation of the durability and function of the new endoscopes smaller than 9Fr.

J S Afane, E O Olweny, E Bercowsky … (2000)

Flexible ureteroscopes smaller than 9Fr are widely used in endourology. We systematically evaluated the functional durability of these instruments in the clinical setting. We performed ureteronephroscopy 92 consecutive times in 84 patients at our hospital using a flexible Storz model 11274AA,double dagger Circon-ACMI model AUR-7, section sign Wolf model 7325.172 parallel and Olympus model URF/P3 ureteroscope paragraph sign. Preoperatively and postoperatively we evaluated all flexible ureteroscopes for luminosity, irrigant flow at 100 mm. Hg, number of broken image fibers and active deflection range. During the procedure a record was kept of the duration that the endoscope remained in the urinary tract, average irrigation pressure, method of insertion, various devices used within the working channel, need for lower pole access, and surgeon overall impression of visibility and maneuverability. The luminosity and irrigant flow of all endoscopes remained relatively unchanged during consecutive applications, while active deflection deteriorated 2% to 28%. Endoscopes were used for an average of 3 to 13 hours before they needed repair. The most fragile part of these instruments was the deflection unit. Small diameter flexible ureteroscopes are effective for diagnosing and treating upper urinary tract pathology but improved durability is required. Currently they represent a highly effective but high maintenance means of achieving retrograde access to the ureter and kidney with a need for repair after only 6 to 15 uses.

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Author and article information

Journal

Journal ID (nlm-ta): Res Rep Urol

Journal ID (iso-abbrev): Res Rep Urol

Journal ID (publisher-id): Research and Reports in Urology

Title: Research and Reports in Urology

Publisher: Dove Medical Press

ISSN (Electronic): 2253-2447

Publication date Collection: 2017

Publication date (Electronic): 27 January 2017

Volume: 9

Pages: 19-25

Affiliations

Department of Urology, The Ohio State University Wexner Medical Center, Columbus, OH, USA

Author notes

Correspondence: Bodo E Knudsen, Department of Urology, The Ohio State University Wexner Medical Center, 915 Olentangy River Rd, Columbus, OH 43212, USA, Tel +1 614 293 9349, Fax +1 614 293 3565, Email Bodo.Knudsen@ 123456osumc.edu

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Publisher ID: rru-9-019

DOI: 10.2147/RRU.S104229

PMC ID: 5293503

PubMed ID: 28203551

SO-VID: 6e958d14-ea74-4c77-b129-fd2459bb486a

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The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

Digital ureteroscopes: technology update

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Most cited references 25

Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model

A new robot for flexible ureteroscopy: development and early clinical results (IDEAL stage 1-2b).

Flexible ureteroscopes: a single center evaluation of the durability and function of the new endoscopes smaller than 9Fr.

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