Improving flexible ureterorenoscope durability up to 100 procedures.

Area of Science:

• Urology
• Medical Devices
• Surgical Instruments

Background:

• Controversy exists regarding the durability of flexible ureterorenoscopy (F-URS) instruments.
• Expected instrument lifespan varies significantly in current literature.
• Tertiary care center experience with consecutive F-URS use is reported to address this.

Purpose of the Study:

• To report on the durability of two consecutive flexible ureterorenoscopy (F-URS) instruments.
• To identify factors contributing to F-URS durability.
• To suggest methods for improving F-URS longevity and reducing costs.

Main Methods:

• Retrospective review of all F-URS procedures performed between July 2009 and February 2011.
• Inclusion of all renal pathology cases; exclusion of ureteral cases.
• Initial use of a 9.5F semirigid ureteroscope for predilation and exploration, followed by sequential F-URS introduction.
• Sterilization method: complete immersion with Cidex®.

Main Results:

• Instruments were replaced after 113 and 102 procedures, with mean operative times of 75 hours 15 minutes.
• Mean procedure duration was 58 minutes, with flexible instruments used for an average of 42 minutes.
• Common causes of damage included deflection mechanism impairment, inner sheath damage, and fiberoptic bundle breaks.

Conclusions:

• Increased flexible ureterorenoscopy (F-URS) durability is influenced by multiple factors, notably the sterilization method.
• Routine initial use of a semirigid ureteroscope significantly contributed to increased F-URS procedures and cost savings.