Improving the durability of digital flexible ureteroscopes

Area of Science:

• Urology
• Medical Device Engineering
• Surgical Technology

Background:

• Digital flexible ureteroscopes are advanced tools in urology.
• Damage to these instruments can lead to significant costs and downtime.
• Understanding damage patterns is crucial for improving longevity.

Purpose of the Study:

• To assess damage to digital flexible ureteroscopes after one year of use.
• To evaluate a strategy for reducing ureteroscope damage.

Main Methods:

• Retrospective analysis of procedures using three new digital flexible ureteroscopes.
• Comparison of damage events before and after implementing safety guidelines and a credentialing process.
• Review of manufacturer repair reports to identify damage causes.

Main Results:

• Five damage events occurred before guideline implementation, primarily during maximum deflection.
• Three damage events occurred after guideline implementation, showing a reduction.
• Ureteroscope lifespan significantly increased from 10.6 to 21.6 uses before damage (P = .035).
• No damage was observed in the imaging system.

Conclusions:

• The optical system of digital flexible ureteroscopes is robust.
• Instrument longevity is highly dependent on proper handling and use.
• Guidelines and monitored training can significantly extend the lifespan of digital flexible ureteroscopes.