Evaluation of a Novel Single-Use Flexible Ureteroscope

Dale, Joanne; Kaplan, Adam; Radvak, Daniela; Shin, Richard; Ackerman, Anika; Chen, Tony; Scales, Charles D.; Ferrandino, Michael N.; Simmons, W. Neal; Preminger, Glenn M.; Lipkin, Michael

doi:10.1089/end.2016.0237

Cited by 56 publications

(59 citation statements)

References 15 publications

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“…Therefore flexible ureteroscopes (FURS) are introduced to the urinary tract and guided to the stone's site where laser application and hence calculi destruction takes place 4 . Different kinds of flexible multi-use endoscopes are available on the market: conventional FURS, in which the image is delivered via a fibre bundle, FURS with attached camera system for image acquisition, and novel digital FURS with "chip on the tip" technology 5,6 . During the last few years huge improvements proceeded to image quality, durability, irrigation flow and reduction of the shaft diameter 3,4,7 , and thus evolved the ureteroscopic Ho:YAG laser lithotripsy to a safer and highly efficient method for calculi destruction 2,8 .…”

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confidence: 99%

“…In the present study a disposable flexible endoscope (PU3022A, Zhuhai PUSEN Medical Technology, Zhuhai, Guangdong China) 16 was systematically tested with special interest in the image quality in terms of spatial resolution and distortion, as well as the maximal bending capability and the irrigation flow. Data were compared to published results 5,17 and two reusable flexible endoscopes currently used in the operating room, a video FURS with attached camera system (FLEX X C , KARL STORZ SE & Co. KG, Tuttlingen Germany) and a fiberoptic FURS device (FLEX X 2S , KARL STORZ SE & Co. KG, Tuttlingen Germany). Additionally destruction tests were performed with one single-use device, whereby the application fibre was withdrawn from +10 mm distance in respect to the working channel outlet to (−2 mm) inside the endoscope.…”

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confidence: 99%

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

Eisel

Strittmatter

Ströbl

et al. 2020

Sci Rep

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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.

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confidence: 99%

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confidence: 99%

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

Eisel

Strittmatter

Ströbl

et al. 2020

Sci Rep

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“…Still, inherent limitations need to be acknowledged. Dale et al [7] have recently published an in vitro study comparing 2 state of the art reusable scopes with a disposable one and have noted a loss of deflection ranging from 2 to 27 degrees on the reusable scope depending on the auxiliary instrument inserted. Conversely, Boylu et al [8] all in an earlier study have demon-Urol Int 2020;104:437-444 DOI: 10.1159/000502759 strated that the disposable scope they compared against reusable ones demonstrated the highest loss in flexion characteristics (35.7% down and 39.3% up), with a similar deficiency in flow rates.…”

Section: Discussionmentioning

confidence: 99%

Ex vivo Comparison of 2 Disposable versus a State-of-the-Art Reusable Ureterorenoscope

Bourdoumis

Howairis²,

Stephen

et al. 2019

Urol Int

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Introduction: The success of upper urinary tract endoscopy on one hand and the high cost of purchase and maintenance of the scopes on the other hand have driven the development of disposable digital flexible ureterorenoscopy (fURS). Materials and Methods:We performed an ex vivo comparison of 2 disposable digital fURS from different companies with a state-of-the-art reusable endoscope from another well-established scope manufacturer. The scopes were tested comparing parameters such as instrument handling, irrigation flow, image quality, and deflection. For the disposable scopes, the latter 2 were evaluated both, before and after vigorous stress testing. Results: Expectedly, the most consistent finding among the 3 instruments was the marked decrease on irrigation flow following insertion of a working element, most notably a guidewire. Depth perception and ergonomic handling were comparable in all 3 instruments.Poststress testing revealed a significant loss of upward deflection in both disposable instruments, more so when an auxiliary instrument is inserted into the working channel. However, this did not appear to be the case in downward deflection. Conclusions: To our knowledge, this is the first study that used a vigorous stress testing protocol comparing disposable and reusable fURS. The newer generation disposable scope fared better than the older one. Results are encouraging and indicate that improvements are ongoing and progressing, bringing the quality of disposable scopes to the level that we are used to from our reusable high performance scopes while at the same time avoiding costly damage repairs. Continuous research and evidence-based interpretation of results in the absence of commercial bias are paramount to ensure this ongoing development.

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“…There are many single‐use digital fURS already on the market, including LithoVue (Boston Scientific, Marlborough, MA, USA), PU3022A (Pusen, Zhuhai, China), Polyscope (Lumenis, Yokneam, Israel, Polydiagnost, Hallbergmoos, Germany), Semi‐Flex Scope (Maxiflex, Los Angeles, CA, USA), FlexoVue (Cook Medical, Bloomington, IN, USA) and Yc‐FR‐A (YouCare Tech, Wuhan, China) . In vitro testing has shown that single‐use scopes have equivalent optics, deflection ability and working channel flow rates to more expensive reusable scopes …”

Section: Introductionmentioning

confidence: 99%

“…11 In vitro testing has shown that single-use scopes have equivalent optics, deflection ability and working channel flow rates to more expensive reusable scopes. [12][13][14][15][16][17] In vivo testing has been limited. A European multicenter evaluation of the single-use LithoVue in 40 procedures found that operators rated the image quality as "good" or "very good" in 95% of cases.…”

Section: Introductionmentioning

confidence: 99%

Single use versus reusable digital flexible ureteroscopes: A prospective comparative study

et al. 2019

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Objectives To compare the performance and surgical outcomes of two different single‐use digital flexible ureteroscopes with a reusable video flexible ureteroscope. Methods Patients undergoing retrograde flexible ureteroscopy at Nepean Hospital, Sydney, Australia, were included in this study. Three different flexible ureteroscopes were used in this study: (i) single‐use digital LithoVue (Boston Scientific, Marlborough, MA, USA); (ii) single‐use digital PU3022A (Pusen, Zhuhai, China); and (iii) reusable digital URF‐V2 (Olympus, Tokyo, Japan). Visibility and maneuverability was rated on a 5‐point Likert scale by the operating surgeon. Operative outcomes and complications were collected and analyzed. Results A total of 150 patients were included in the present study. Of these, 141 patients had ureteroscopy for stone treatment, four for endoscopic combined intrarenal surgery and five for diagnostic/tumor treatment. There were 55 patients in the LithoVue group, 31 in the PU3022A group and 64 patients in the Olympus URF‐V2 group. The URF‐V2 group had higher visibility scores than both the single‐use scopes and higher maneuverability scores when compared with the PU3022A. The LithoVue had higher visibility and maneuverability scores when compared with the PU3022A. There were no differences in operative time, rates of relook flexible ureteroscopes, scope failure or complication rates observed. Conclusions Single‐use digital flexible ureteroscopes have visibility and maneuverability profiles approaching that of a reusable digital flexible ureteroscope. Single‐use flexible ureteroscopes achieve similar clinical outcomes to the more expensive reusable versions.

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Evaluation of a Novel Single-Use Flexible Ureteroscope

Abstract: The LithoVue Single-Use Digital ureteroscope has comparable optical capabilities, deflection, and flow, making it a viable alternative to standard reusable fourth-generation flexible digital and fiberoptic ureteroscopes.

Cited by 56 publications

References 15 publications

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

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

Ex vivo Comparison of 2 Disposable versus a State-of-the-Art Reusable Ureterorenoscope

Single use versus reusable digital flexible ureteroscopes: A prospective comparative study

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