Munich, Germany (UroToday.com) Cystoscopy and ureteroscopy is the most commonly performed urologic procedures. Traditionally flexibile or rigid scopes are used for the procedure. Average lifespan of a flexible scope is about 20 procedures and associated with significant cost and maintenance.
Kaplan and colleagues evaluated and compared a novel single use flexible ureteroscope to contemporary flexible ureteroscope, with regards to optics, ureteroscope deflection and irrigation flow.
Three flexible ureteroscopes including the LithoVue (Single Use, Boston Scientific, USA), Flex-Xc (Karl Storz, Germany) and Cobra (Richard Wolf, Germany) were assessed in vitro for image resolution, distortion, color representation, grayscale imaging, field of view and depth of field. Ureteroscope deflection was tested with an empty channel followed by placement of a 200μm laser fiber and a 1.9F wire basket, a 2.0F Nanoelectric pulse lithotripsy (NPL) probe and a 2.4F NPL probe. Ureteroscope irrigation flow was measured using normal saline at 100cm, with an empty channel followed by a 200μm laser fiber, a 1.9F wire basket and a 2.0F NPL probe.
The novel LithoVue showed the largest field of view, with excellent resolution, image distortion and depth of field. No differences were found in color reproducibility. The LithoVue maintained full deflection ability with all instruments, though the Flex-Xc and Cobra showed loss of deflection ranging from 2° to 27° depending on the instrument placed. With an empty channel, the LithoVue showed a flow rate greater than the Flex-XC (p=0.003) and the Cobra (p<0.001). It maintained better flow with instruments in the channel than the Flex-Xc. The Cobra has a separate 3.3F instrument channel, keeping flow rates the same with instrument insertion.
Cobra remains one of the best contemporary flexible ureteroscopes. LithoVue has the potential to be improved in design and charteristics until it becomes fully utilized device.
Presented By:
Kaplan A.G.
From the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany