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994: Comparison of eight digital (reusable and disposable) flexible ureteroscopes deflection properties: In-vitro study in 10 different scope settings

Speaker
M. Rodriguez-Monsalve Herrero, Majadahonda (ES)
Authors
Dragos L.B. 1 , Rodriguez-Monsalve Herrero M. 2 , Somani B.K. 3 , Keller E.X. 2 , De Coninck V. 2 , Martis S.M. 4 , Bres-Niewada E. 5 , Sener T.E. 6 , Buttice S. 7 , Daminescu L.C. 4 , Pupca G.N. 1 , Bardan R.T. 1 , Cumpanas A.A. 1 , Iacoboaie C. 2 , Doizi S. 2 , Traxer O. 8
Institutions
1University of Medicine and Pharmacy, Dept. of Urology, Timisoara, Romania, 2Tenon Hospital, Dept. of Urology, Paris, France, 3University Hospital Southampton NHS Trust, Dept. of Urology, Southampton, United Kingdom, 4Emergency Clinical County Hospital, Dept. of Urology, Timisoara, Romania, 5Medical University of Warsaw, Dept. of Urology, Warsaw, Poland, 6Marmara University, Dept. of Urology, Istanbul, Turkey, 7San Giovanni di Dio Hospital, Dept. of Urology, Agrigento, Italy, 8Tenon Hospital, Sorbonne Universités, UPMC Paris VI, Groupe de Recherche Clinique sur la Lithiase Urinaire, GRC nº20, Dept. of Urology, Paris, France, 9
Event
33rd Annual EAU Congress Copenhagen
Date – time - Location
19 March 2018, 14:00 - 15:30, Green Area, Room 1 (Level 0)
Session
Poster Session 73 - Safe access through natural orifice: It is the era of ureteroscopy
Topic
Stones: Ureteroscopy

Introduction & Objectives

Due to the high cost and fragility of the reusable digital flexible ureterorenoscopes (fURSs), several single use alternatives have emerged. The goal of our in-vitro study was to determine the deflection properties of these scopes with the working channel empty and occupied by different accessories.

Materials & Methods

Four single-use (LithoVue, Boston Scientific, USA; Pusen, China; Neoflex, Neoscope, USA; YouCare Tech, China) and four reusable (URF-V2, Olympus, Japan; Flex Xc, Karl Storz, Germany; Cobra vision and Boa vision, Richard Wolf, Germany) fURSs were compared in a total of 10 different settings.
The maximal up and down deflection was measured with the working channel empty and then occupied with various tools (200µm, 273µm, 365µm laser fibres; 1.5Fr, 1.9Fr, 2.2Fr baskets; 0.038” PTFE, 0.035”Terumo guidewires; Piranha biopsy forceps). Each measurement was performed three times. Deflection angles were calculated using a protractor. A scoring system by adding the total deflection degrees for each scope and each setting was used to compare the fURSs.

Results

When the channel was occupied, the most cumulative deflection was achieved by NeoFlex (5043º) and the least by YouCare Tech (3912º) (Fig.1,2). The least affect on deflection was caused by the 200µm laser fibre (2198º) for the disposable fURSs, and by 1.5 Fr basket (1971º) for the reusable fURSs. In both reusable and disposable fURSs, the PTFE guidewire caused the maximum impact on scope deflection (Fig.3).
Overall, single-use fURSs had better deflection in most settings, except when 365 µm laser fibre or guidewires (both PTFE and nitinol) were occupying the working channel (Fig.3).

Image

Conclusions

The single-use fURSs seem to have better in-vitro deflection than the reusable scopes. But when thicker, less flexible tools occupied the working channel, the reusable fURSs deflected better. Further evaluation of our findings in clinic settings will help to confirm our findings.