Evaluation of overall costs of currently available small flexible ureteroscopes

Landman, Jaime; Lee, David I.; Lee, Courtney; Monga, Manoj

doi:10.1016/s0090-4295(03)00376-5

Cited by 89 publications

(48 citation statements)

References 2 publications

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“…Rarely has upfront investment for the purchase of the fURS been considered in such analyses, while the cost of reprocessing has never been included. 3,5,17 We found that repairs account for the majority of expense (70-75%) and after 100 uses are nearly three times greater than the purchase price of the fURS itself. Distribution of costs between investment, repairs, and reprocessing was similar whether list pricing or discount rates were used and did not significantly differ for digital or fiberoptic models.…”

Section: Discussionmentioning

confidence: 79%

“…Cumulative costs of fURS ownership after 100 cases can vary by as much as 95% between models. 3 Reprocessing costs may vary by institution as well. We suspect ours is on the low end, reflecting high familiarity from a large case volume; however, further multicenter studies are necessary to verify this.…”

Section: Discussionmentioning

confidence: 99%

“…2 One common criticism of fURSs is the high cost of ownership. 3,4 In particular, fURS repair costs are substantial, making durability a critical component of investing in a new reusable scope. 5,6 Repair costs are such a concern that single use disposable ureteroscopes are being developed to avoid costly scope damages and repairs altogether.…”

Section: Introductionmentioning

confidence: 99%

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Comprehensive Costs Associated with Fiberoptic and Digital Flexible Ureteroscopes at a High Volume Teaching Hospital

et al. 2017

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comprehensive Costs Associated with Fiberoptic and Digital Flexible Ureteroscopes at a High Volume Teaching Hospital

et al. 2017

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“…1,2 Commensurate with continued ureteroscope miniaturization has been increased instrument fragility, time in which the equipment is not available, and repair and maintenance costs. 3 The most common application of the ureteroscope is for urolithiasis. For endoscopic stone treatment, the holmium:yttrium-aluminum-garnet (Ho:YAG) and neodymium:yttrium-aluminum-garnet laser has become an indispensable adjunct for many urologists.…”

Section: Introductionmentioning

confidence: 99%

“…For endoscopic stone treatment, the holmium:yttrium-aluminum-garnet (Ho:YAG) and neodymium:yttrium-aluminum-garnet laser has become an indispensable adjunct for many urologists. Landman and coworkers 3 documented that 70% of the ureteroscope failures are the result of the incorrect use of holmium laser energy. While endoscope damage from laser energy is well recognized, mechanical damage to the working channel because of repeated insertions of laser fibers is a less recognized and appreciated mechanism for ureteroscope damage via working channel perforation.…”

Section: Introductionmentioning

confidence: 99%

In Vitro Evaluation of ScopeSafe Fibers and the Scope Guardian Sheath in Prevention of Ureteroscope Endolumenal Working Damage

Lusch

Abdelshehid

Liss

et al. 2013

Journal of Endourology

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Background and Purpose: Ureteroscope breakage is commonly related to laser fiber damage. Often, the damage is mechanical and not energy related. As such, we evaluated a novel laser fiber and sheath system in preventing mechanical ureteroscope damage during fiber insertion. Materials and Methods:We assessed 200-lm/272/3-lm laser fibers with the laser sheath in a flexible ureteroscope. Diminishment of active deflection and irrigation flow rates were compared with a standard laser fiber alone. Eight nonassembled working channel components were tested in a 0-degree/90-degree/210-degree deflection model. After insertion cycles, external and endolumenal damage to the working channel were classified. We also tested the sheath system in a 0-degree/90-degree/210-degree deflection model for fiber failure and laser damage. Results: In all test trials with the sheath and for standard laser fibers in the 0-degree model, there were no channel perforations or damage. With standard laser fibers, in the 210-degree model, superficial scratches and demarcated abrasions were visible after 10 and 60 to 70 insertions for the 273-lm laser fiber and after 30 insertions (superficial scratches) for the 200-lm laser fiber. In the 90-degree model, superficial scratches occurred after 20 insertions for the 273-lm fibers and after 40 insertions for the 200-lm laser fibers. No demarcated abrasions were seen after 100 insertions. In the 210-degree model, there was one perforation with the 272-lm fiber, but none with 200-lm fiber. There were no fiber failures with sheath use; however, the sheath did not prevent laser energy damage. The laser sheath resulted in a 4.7-degree/3.8-degree (1.2%/1.5%) diminishment in deflection (up/down) for the 200 lm and a 3.5-degree/4.3-degree (1.8%/1.5%) diminishment for 272-lm laser fiber compared with standard 200/272-lm laser fiber. Irrigation flow was diminished with the sheath on both the 200-lm and 272-lm laser fiber by 28.7% and 32.6%, respectively. Conclusion: The Scope Guardian Sheath prevented mechanical working channel damage with minimal diminishment of deflection and irrigation flow.

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Ureteroscopy Complications

Abbott

Sur

2018

Smith's Textbook of Endourology

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Evaluation of overall costs of currently available small flexible ureteroscopes

Cited by 89 publications

References 2 publications

Comprehensive Costs Associated with Fiberoptic and Digital Flexible Ureteroscopes at a High Volume Teaching Hospital

Comprehensive Costs Associated with Fiberoptic and Digital Flexible Ureteroscopes at a High Volume Teaching Hospital

In Vitro Evaluation of ScopeSafe Fibers and the Scope Guardian Sheath in Prevention of Ureteroscope Endolumenal Working Damage

Ureteroscopy Complications

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