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Current Disposable Ureteroscopes: Performance and Limitations in a Standardized Kidney Model.
Daniel Schlager1, Moaaz Abdulghani Obaid1, Simon Hein1
1Department of Urology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Germany.
Journal of Endourology
|June 2, 2020
Summary
Single-use flexible ureteroscopes show promise, with LithoVue and the new Uscope UE3022 offering comparable performance to reusable scopes for stone extraction. However, single-use devices generally had longer completion times.
Area of Science:
- Urology
- Medical Devices
- Endourology
Background:
- Increasing instrument fragility and reprocessing concerns drive demand for single-use flexible ureteroscopes.
- Evaluating the performance of new disposable ureteroscopes against traditional reusable models is crucial for clinical adoption.
Purpose of the Study:
- To compare the visualization, stone extraction efficacy, and surgeon workload of currently available disposable flexible ureteroscopes against a reusable device.
- To assess the performance of LithoVue, Pusen Uscope (UE3011, UE3022), and FlexorVue against the BOA Vision reusable ureteroscope.
Main Methods:
- Kidney models were used to test four flexible ureteroscopes: LithoVue, Pusen Uscope (UE3011, UE3022), FlexorVue, and BOA Vision (reusable).
- Evaluation included visualization of calices, human calculi extraction using a standard device, and time to completion.
- Surgeon workload and performance were assessed using the National Aeronautics and Space Administration-Task Load Index.
Main Results:
- LithoVue and Uscope demonstrated comparable calice visualization to the reusable scope, though single-use devices had longer completion times.
- LithoVue achieved high stone clearance rates (97%), similar to the reusable scope. Uscope UE3022 showed improved stone retrieval times (65s/stone) surpassing the reusable scope.
- FlexorVue performance was unsatisfactory. Uscope UE3022 offered the best image quality, though not significantly different from others.
Conclusions:
- LithoVue provides performance comparable to reusable ureteroscopes, representing a viable single-use alternative.
- The Uscope UE3022 shows significant improvement, offering competitive stone extraction and image quality.
- FlexorVue requires further development for clinical utility, while the first-generation Uscope needs enhancements.
