T Inoue1,2, S Okada3, S Hamamoto4, H Miura5, J Matsuzaki6, M Tambo7, H Fukuhara7, M Fujisawa8, T Matsuda9, K Nutahara10. 1. Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Hyogo, Japan. inouetak@harahospital.jp. 2. Department of Urology and Stone Center, Hara Genitourinary Hospital, Tyuou-ku, Kitanagasa-tori 5-7-17, Kobe, Hyogo, 650-0012, Japan. inouetak@harahospital.jp. 3. Department of Urology, Gyotoku General Hospital, Chiba, Japan. 4. Department of Nephro-Urology, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan. 5. Department of Urology, Clinic of Hachinohe Koyo, Aomori, Japan. 6. Department of Urology, Ohguchi Higashi General Hospital, Kanagawa, Japan. 7. Department of Urology, Kyorin University School of Medicine, Tokyo, Japan. 8. Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Hyogo, Japan. 9. Department of Urology and Andrology, Kansai Medical University, Osaka, Japan. 10. Department of Urology, Bremen Street Urology and Nephrology Clinic, Kanagawa, Japan.
Abstract
PURPOSE: To compare the range of reach of our newly designed omni-directional ureteroscope (URF-Y0016), compared to the commonly used URF-P6, FlexX2s, and LithoVue™ scopes, in the upper, middle, and lower calyces in an ex-vivo pyelocaliceal model. METHODS: We fabricated a three-dimensional pyelocaliceal model of the upper, middle, and lower pole calyces using urethane and acrylic resin. The inner surface of the dome of each calyx was engraved with reference lines along eight directions, set at 10° of latitude from the top to the base of the dome, and at angles of 0-90°, to precisely determine the range of reach of each scope. The main feature of the URF-Y0016 scope is the omni-directional bending of the tip of the flexible ureteroscope, with the control of these four directions integrated into a handgun-type control unit with a joystick. The range of reach within each calyx was measured by four expert surgeons. RESULTS: The URF-Y0016 scope provided a greater range of reach along all directions in the lower pole calyx compared to URF-P6, FlexX2s, and LithoVue™ scopes (p < 0.001), particularly along the anterior-posterior direction in the lower lobe calyx. However, the URF-Y0016 scope did not influence the improvement of reach range in the upper and middle pole calyx compared to URF-P6, FlexX2s, and LithoVue™ scopes (p = 0.08, p = 0.296). CONCLUSION: The novel design of the URF-Y0016 could improve treatment outcomes for calyceal stones in the lower pole in practice.
PURPOSE: To compare the range of reach of our newly designed omni-directional ureteroscope (URF-Y0016), compared to the commonly used URF-P6, FlexX2s, and LithoVue™ scopes, in the upper, middle, and lower calyces in an ex-vivo pyelocaliceal model. METHODS: We fabricated a three-dimensional pyelocaliceal model of the upper, middle, and lower pole calyces using urethane and acrylic resin. The inner surface of the dome of each calyx was engraved with reference lines along eight directions, set at 10° of latitude from the top to the base of the dome, and at angles of 0-90°, to precisely determine the range of reach of each scope. The main feature of the URF-Y0016 scope is the omni-directional bending of the tip of the flexible ureteroscope, with the control of these four directions integrated into a handgun-type control unit with a joystick. The range of reach within each calyx was measured by four expert surgeons. RESULTS: The URF-Y0016 scope provided a greater range of reach along all directions in the lower pole calyx compared to URF-P6, FlexX2s, and LithoVue™ scopes (p < 0.001), particularly along the anterior-posterior direction in the lower lobe calyx. However, the URF-Y0016 scope did not influence the improvement of reach range in the upper and middle pole calyx compared to URF-P6, FlexX2s, and LithoVue™ scopes (p = 0.08, p = 0.296). CONCLUSION: The novel design of the URF-Y0016 could improve treatment outcomes for calyceal stones in the lower pole in practice.
Entities:
Keywords:
Joystick handle; Lower pole access; New technology of fURS; Omni-directional bending