Comparative investigation of reusable and single–use flexible endoscopes for urological interventions

Abstract

In order to evaluate the technical adaptability of a type of disposable endoscope compared to reusable flexible endoscopes, in vitro and in vivo studies were conducted. A disposable digital ureteroscope ("chip on tip") and two reusable endoscopes were investigated with respect to spatial resolution, geometric distortion in air and water the maximum. Additionally, the clinical performance of the disposable device was tested during clinical procedures (n = 20). The disposable endoscope showed an optical resolution of 6.72 lines/mm at 10 mm distance, similar to the other devices. In comparison, the disposable endoscope showed a barrel-shaped image distortion in air of −24.2%, which is in the middle range, but was best under water (−8.6%). The bendability of 297° (275 µm fiber) and 316° (empty channel, 1.5 F basket) and the maximum irrigation (1 m: 58.1 ml/min, 2 m: 91.9 ml/min) were convincing. Clinically the maneuverability was very good in (13/20), good or satisfactory in (7/20). Visibility was evaluated as very good in (11/20), just in (1/20) either satisfactory or sufficient. The consistency of visibility was not affected in (19/20). In all cases there were no adverse events. The technical examination and clinical application of the disposable endoscope are of equal quality compared to reusable devices. Disposable endoscopes can be an alternative to reusable devices, but economic aspects such as reduction of repair costs, sterilization effort and additional waste must be taken into account.

Disposable versus Reusable Ureteroscopes: A Prospective Multicenter Randomized Comparison

“…deflection angles, manoeuvrability, flow rate, SFR) through the use of in vitro, ex vivo and in vivo models. [15][16][17] To the best of our Again, the authors find that optical resolution is comparable across the two instruments, but they also find that image distortion in water, bendability and irrigation capacity are better in disposable ureteroscopes. All in all, these papers provide evidence that disposable and reusable ureteroscopes are comparable in terms of quality and efficacy.…”

“…All in all, these papers provide evidence that disposable and reusable ureteroscopes are comparable in terms of quality and efficacy. [15][16][17] As far as costs are concerned, our study shows that procedures that employ disposable ureteroscopes are not significantly more expensive than those that utilize reusable ureteroscopes. As previously described, the average cost of reusable ureteroscopes includes the cost of hospitalization days, the cost of antibiotic therapy, the average cost of repair for the reusable instrument, sterilization and reprocessing costs (which include personnel cost, amortization of the sterilizing machine and amortization of the reusable tool).…”

“…The authors find similar optical capabilities, deflection angles and flow rates across the two types of instruments. A recent study by Eisel et al 17 compares the technical characteristics of in vitro and in vivo disposable flexile ureteroscope PU3022A (Zhuhai PUSEN Medical Technology, Zhuhai, Guangdong, China) with two disposable reusable ones, a digital one (Flex X c , KARL STORZ SE & Co. KG, Tuttlingen, Germany) and a fiberoptic one (Flex X 25 , KARL STORZ SE & Co. KG, Tuttlingen, Germany). Again, the authors find that optical resolution is comparable across the two instruments, but they also find that image distortion in water, bendability and irrigation capacity are better in disposable ureteroscopes.…”

“…8 Several recent studies compare single-use and multiuse ureteroscopes in order to determine whether the two are comparable from a technical point of view. [15][16][17] These analyses compare image quality in terms of resolution, field of view, image distortion and performance (i.e. deflection angles, manoeuvrability, flow rate, SFR) through the use of in vitro, ex vivo and in vivo models.…”

Relevance of Adopting a Hybrid Strategy Mixing Single-Use and Reusable Ureteroscopes for Stones Management: An Economic Study to Support the Best Strategy

“…Since 2015, single-use flexible ureteroscopes (sURSs) have been a major technological advancement in urolithiasis management. Their clinical performance and functional capabilities are comparable [2,3] to those of reusable ureteroscopes (rURSs). However, rURSs have disadvantages: they are fragile and prone to damage, and need to be reprocessed and maintained.…”