New-generation flexible ureterorenoscopes are more durable than previous ones

Area of Science:

• Urology
• Medical Device Engineering

Background:

• Flexible ureteroscopes (URS) are crucial for minimally invasive urologic procedures.
• Assessing the long-term performance and durability of new-generation URS is essential for clinical practice.

Purpose of the Study:

• To evaluate the functional deterioration of a new-generation flexible ureteroscope (URS) after repeated use.
• To quantify changes in active deflection, irrigation flow, and fiber integrity over 50 procedures.

Main Methods:

• Fifty ureterorenoscopies were performed using a single Karl Storz 11278 AU1 Flex-X ureteroscope.
• Maximal active deflection (ventral/dorsal), irrigation flow rate, and optical fiber integrity were assessed postoperatively.
• Total usage time and instances of repair were recorded.

Main Results:

• Maximal ventral deflection decreased from 270° to 208°, and dorsal deflection from 270° to 133° over 50 procedures.
• Irrigation flow decreased from 50 mL/min to 40 mL/min.
• Six broken optical fibers were noted, and one laser perforation of the working channel required repair.

Conclusions:

• New-generation flexible ureteroscopes exhibit notable deterioration in performance with use.
• While repairs may be less frequent, enhanced durability is critical for the widespread adoption of flexible URS technology.
• Minimizing laser-induced damage to the working channel remains a key area for future improvement.