1391 THE IMPACT OF DIFFERENT UPPER URINARY TRACT BIOPSY DEVICES ON THE PERFORMANCE OF FLEXIBLE URETERORENOSCOPES: STANDARDIZED EX VIVO COMPARISON

Abstract

You have accessJournal of UrologyTechnology & Instruments: Ureteroscopy1 Apr 20111391 THE IMPACT OF DIFFERENT UPPER URINARY TRACT BIOPSY DEVICES ON THE PERFORMANCE OF FLEXIBLE URETERORENOSCOPES: STANDARDIZED EX VIVO COMPARISON Christian Bolenz, Manuel Ritter, Thorsten Bach, Maurice Stephan Michel, and Axel Häcker Christian BolenzChristian Bolenz Mannheim, Germany More articles by this author , Manuel RitterManuel Ritter Mannheim, Germany More articles by this author , Thorsten BachThorsten Bach Hamburg, Germany More articles by this author , Maurice Stephan MichelMaurice Stephan Michel Mannheim, Germany More articles by this author , and Axel HäckerAxel Häcker Mannheim, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1238AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Diagnostic and staging errors are common problems in the management of upper tract urothelial lesions. Biopsy forcipes for flexible ureterorenoscopes have been developed to improve diagnostic accuracy. Newly developed biopsy devices allow for acquisition of larger tissue samples but may complicate the handling of ureterorenoscopes. We evaluated the influence of 5 different biopsy forcipes on the deflection, irrigant flow and optical characteristics of 3 different flexible ureterorenoscopes. METHODS Five different biopsy forcipes were compared: Olympus (FB-56D-1;diameter 5Fr.), R. Wolf (829.601;3Fr.), Karl Storz Medical (11275ZE;3Fr.), Boston Scientific (Piranha; 505–160;3 Fr.) and the backloading Cook BIGopsy (115CM;2.4 Fr.) device. The devices were tested in 3 different ureterorenoscopes: Storz 11278VU (Flex-X2), Storz 11278V (Flex-XC) and Wolf Cobra (7326071/-6). Active deflection (angle), irrigation flow rates (ml/min) and optical characteristics (field of view) were evaluated, each with an empty working channel and with inserted biopsy device. RESULTS Baseline irrigation flow rates were significantly higher in the Wolf Cobra than in Storz ureterorenoscopes (30.5 vs. 23 and 21 ml/min). The separate working channel of the Wolf Cobra provided unchanged flow rates with inserted biopsy forceps. A significant reduction of irrigation flow was observed in Storz Flex-X2 (maximum 1.3 ml/min) and Storz Flex-XC (2.2 ml/min) with any forceps inserted. No differences in irrigation flow rates were found with introduced biopsy device when the scopes were deflected or straight. The BIGopsy forceps provided higher flow rates in both Storz scopes (2.2 and 1.3, respectively) when compared to the other devices (0.5 and 0.6 ml/min). The Storz and Wolf biopsy forcipes resulted in the highest impairment of deflection angle (minus 95, 123 and 114 degrees, respectively). In all 3 ureterorenoscopes flow rates and angle of deflection were least impaired by BIGopsy. Insertion of the BIGopsy device in any ureterorenoscope reduced the field of view by at least 20% compared to a maximum of 12% reduction caused by the other forcipes. CONCLUSIONS The various biopsy devices differ in the impairment of irrigation flow rates, degree of deflection and reduction of field of view. The Cook BIGopsy forceps allows for the least impairment of irrigation flow in single-channel flexible ureterorenoscopes due to a smaller diameter and does not significantly impair deflection. However, a smaller field of view may hamper tissue acquisition. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e555-e556 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Christian Bolenz Mannheim, Germany More articles by this author Manuel Ritter Mannheim, Germany More articles by this author Thorsten Bach Hamburg, Germany More articles by this author Maurice Stephan Michel Mannheim, Germany More articles by this author Axel Häcker Mannheim, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...