In Vitro Evaluation of Single-Use Digital Flexible Ureteroscopes: A Practical Comparison for a Patient-Centered...

Area of Science:

• Urology
• Medical Devices
• Surgical Technology

Background:

• Flexible ureteroscopes are crucial for minimally invasive urological procedures.
• Advancements in single-use technology aim to improve performance and reduce risks associated with reusable scopes.
• Comparing the in vitro performance of new single-use flexible ureteroscopes with established reusable models is essential for clinical adoption.

Purpose of the Study:

• To conduct a comparative in vitro analysis of two single-use flexible ureteroscopes (LithoVue and Pusen) against a permanent reusable ureteroscope (Flex-X²).
• To evaluate manufacturing and performance characteristics, including optics, deflection, and irrigation flow, to inform surgical technique and device selection.

Main Methods:

• Technical characteristics, optical performance (resolution, field of view, color representation), deflection mechanism, and irrigation flow rates were assessed for LithoVue, Pusen, and Flex-X².
• Standardized in vitro testing protocols were employed to ensure comparability.

Main Results:

• LithoVue demonstrated superior optical resolution and wider field of view compared to both Pusen and Flex-X².
• LithoVue exhibited better deflection capacity, while Pusen offered the highest irrigation flow with an empty channel.
• Flex-X² provided superior color representation, but Pusen and LithoVue showed better irrigation flow rates when using instruments.

Conclusions:

• The LithoVue single-use flexible ureteroscope offers significant advantages in optical resolution, field of view, deflection, and irrigation with larger instruments.
• The Pusen single-use scope is lighter and provides better irrigation without instruments, while the reusable Flex-X² excels in color representation.
• These findings highlight the distinct performance characteristics of single-use versus reusable flexible ureteroscopes, guiding selection based on specific procedural needs.