Digital Flexible Ureteroscope: Evaluating Factors Responsible for Damage and Implementing a Mandatory Certification...

Area of Science:

• Urology
• Medical Device Engineering
• Healthcare Management

Background:

• Digital flexible ureteroscopes (DFUs) are vital in endourology.
• DFU breakages are often preventable.
• Optimizing DFU durability is key to reducing costs and improving procedural efficiency.

Purpose of the Study:

• To evaluate the impact of mandatory training on DFU durability.
• To identify factors influencing DFU damage and lifespan.
• To assess the economic implications of DFU maintenance.

Main Methods:

• Implemented mandatory training on DFU care for all relevant staff.
• Restricted DFU handling to certified personnel with meticulous documentation.
• Compared DFU usage pre- and post-training using negative binomial regression to analyze influencing factors.

Main Results:

• DFU average annual usage increased by 21% post-training (6.38 to 7.74 cases).
• Post-graduate year, prior ureteral stent use, struvite stones, and stone burden were significant factors affecting DFU durability.
• In situ lithotripsy in the lower calyx was associated with reduced DFU procedures before breakage.

Conclusions:

• Mandatory training significantly enhances DFU durability, potentially cutting repair and replacement costs by 21%.
• Experienced practitioners and careful consideration of stone characteristics improve DFU lifespan.
• Standardized training and careful handling protocols are crucial for maintaining DFU integrity.