Integrated Real-Time Digital Measurement During Ureteroscopic Procedures for Nephrolithiasis: A Workflow Feasibility
Kevin Koo1, Tareq Aro1,2, Russell E N Becker1
1Department of Urology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Journal of Endourology
|April 16, 2020
Summary
Accurate stone fragment size estimation during ureteroscopy is crucial. A novel digital measurement software integrated into ureteroscopy is safe and feasible, aiding operative decisions.
Area of Science:
- Urology
- Medical Technology
- Surgical Innovation
Background:
- Accurate estimation of ureteral stone fragment size is vital for operative efficiency and predicting stone passage.
- Current methods for stone size estimation during ureteroscopy lack precision and real-time integration.
Purpose of the Study:
- To assess the feasibility of integrated real-time digital stone measurement during ureteroscopy using novel software.
- To evaluate the impact of digital stone measurement on operative efficiency and safety.
Main Methods:
- A two-phase workflow feasibility study: ex vivo simulation with mock stones and in vivo trial with human patients.
- Ex vivo phase: compared basketing task time with and without digital measurement.
- In vivo phase: prospectively enrolled patients undergoing ureteroscopy to measure intraoperative stone fragments and record time, technical failures, and complications.
Main Results:
- Ex vivo: Digital stone measurement added an average of 22.3 seconds to the basketing task.
- In vivo: Mean completion time per measurement was 10.1 seconds, with a total mean procedural time of 50.8 seconds for digital measurements.
- No technical failures or clinical complications were observed in the in vivo trial.
Conclusions:
- Integrating real-time digital stone measurement into ureteroscopy is safe and feasible.
- The findings support further clinical trials to explore digital stone measurement for enhanced intraoperative decision-making in ureteroscopy.
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