Are new-generation flexible ureteroscopes better than their predecessors?

Area of Science:

• Urology
• Medical Devices
• Endoscopy

Background:

• Flexible ureteroscopes are crucial for diagnosing and treating lower pole renal pathology.
• Tip deflection limitations can hinder effective diagnosis and treatment.
• Previous ureteroscope models faced challenges with maintaining deflection when instruments were inserted.

Purpose of the Study:

• To compare the tip deflection and performance of two new-generation flexible ureteroscopes against their predecessors.
• To evaluate if design advancements have improved the handling of lower pole renal pathology.
• To assess the impact of endoscopic tools on the tip deflection and flow rates of new ureteroscopes.

Main Methods:

• Two new flexible ureteroscopes (ACMI DUR-8 Elite, Storz 11278AU) were compared with their older models (ACMI DUR-8, Storz 11274AAU).
• Active tip deflection and irrigation flow rates were measured with and without endoscopic tools.
• Specifications, purchase prices, and repair costs were obtained; field of view and image size were also compared.

Main Results:

• The ACMI DUR-8 Elite and Storz 11278AU showed significant improvements in tip deflection (79 and 144 degrees, respectively).
• Newer models experienced less loss of tip deflection with endoscopic tools inserted (0.7% and 2.8% loss vs. 9.6% and 5.0%).
• Flow rates were decreased in the new ureteroscope models.

Conclusions:

• New flexible ureteroscopes demonstrate superior active tip deflection compared to older models, even with instruments inserted.
• Improved flexibility comes at the cost of reduced flow rates.
• Higher purchase costs are associated with the new ureteroscope designs.