Enhanced Pressure Management Using an Upgraded Vacuum-Assisted Ureteroscopic System: Experimental Validation and...

Area of Science:

• Urology
• Medical Devices
• Surgical Technology

Background:

• Ureteroscopy is a common procedure for treating kidney stones.
• Managing intrapelvic pressure and ensuring adequate irrigation are critical for safety and efficacy.
• Traditional ureteroscopy (T-URS) can lead to high intrapelvic pressures.

Purpose of the Study:

• To compare the pressure-control performance and irrigation efficiency of an upgraded vacuum-assisted ureteroscopic system (VA-URS) against traditional ureteroscopy (T-URS).
• To evaluate these systems using an in vitro kidney model under various simulated conditions.

Main Methods:

• An artificial renal pelvis model was utilized to simulate ureteroscopy.
• Experiments were conducted under varying irrigation pressures (50, 100, 150 cmH₂O) and flow rates (30-50 mL/min).
• Intrapelvic pressure and effective irrigation flow rates were continuously measured; statistical analyses included Three-way ANOVA and multiple regression models.

Main Results:

• VA-URS consistently demonstrated significantly lower intrapelvic pressures compared to T-URS across all tested settings (e.g., -21.47 vs. 24.73 cmH₂O at 50 cmH₂O/30 mL/min; P < 0.01).
• Effective irrigation flow rates were higher with VA-URS (20.40 vs. 24.50 mL/min at 50 cmH₂O/30 mL/min; P < 0.01).
• Regression models confirmed strong predictive accuracy (R² = 0.984 for VA-URS) and highlighted distinct pressure-flow dynamics between the two systems.

Conclusions:

• The upgraded VA-URS system significantly improves intrapelvic pressure management and irrigation efficiency compared to T-URS in an in vitro setting.
• These findings suggest potential clinical benefits for VA-URS.
• Further animal and clinical studies are warranted to validate the clinical efficacy and safety of VA-URS.