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

Joao G Porto1, Ansh Bhatia1, Renil S Titus2

  • 1Miller School of Medicine, Desai Sethi Urology Institute, University of Miami, Miami, Florida, USA.

Journal of Endourology
|October 25, 2024
PubMed
Summary
This summary is machine-generated.

Mandatory training for digital flexible ureteroscopes (DFUs) increased scope durability by 21%. Experienced staff and specific stone types influenced instrument longevity, potentially reducing repair costs.

Keywords:
digital flexible ureteroscopekidney stonesmandatory trainingquality improvement

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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.