1813 PROSPECTIVE EVALUATION OF REFURBISHED FLEXIBLE URETEROSCOPE DURABILITY SEEN IN A LARGE PUBLIC TERTIARY CARE CENTER WITH MULTIPLE SURGEONS

Abstract

You have accessJournal of UrologyStone Disease: SWL, Ureteroscopy or Percutaneous Stone Removal (III)1 Apr 20131813 PROSPECTIVE EVALUATION OF REFURBISHED FLEXIBLE URETEROSCOPE DURABILITY SEEN IN A LARGE PUBLIC TERTIARY CARE CENTER WITH MULTIPLE SURGEONS Robert Carey, Christopher Martin, and Jacob Knego Robert CareyRobert Carey Sarasota, FL More articles by this author , Christopher MartinChristopher Martin Sarasota, FL More articles by this author , and Jacob KnegoJacob Knego Sarasota, FL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2176AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The purpose of this paper is to evaluate the durability and cost of maintenance for out-sourced, refurbished flexible ureteroscopes. Many hospitals provide flexible ureteroscopes through a contract with an out-sourced vendor, not the original manufacturer. Although new and manufacturer refurbished scopes have been evaluated and compared, vendor out-sourced refurbished flexible ureteroscopes have never been critically examined in a large prospective study designed to evaluate durability and cost. METHODS Ureteroscope usage and repair was prospectively recorded over a 365 day period at a large 836 bed public hospital. Cases were performed by 14 different urologists using either refurbished DUR-8 or DUR-8 Elite model ureteroscopes. Retrograde cases involving calculi, urothelial carcinoma, stricture, and diagnostic evaluations were included. Ureteroscope repairs were performed by a single out-sourced repair vendor, not the original manufacturer. RESULTS A total of 501 ureteroscopic cases involving 550 ureteroscope usages were performed over a 365 day period. Semi-rigid ureteroscopes were used for 281 (56.1%) cases, refurbished flexible ureteroscopes for 220 (43.9%). The reason for the ureteroscopy was calculi in 386 (77.0%) cases, urothelial carcinoma in 32 (6.4%), stricture in 36 (7.2%), and diagnostic in 47 (9.4%). No repairs were needed during this time period for semi-rigid scopes. Ureteral access sheaths were employed in 82 (37.7%) of the cases. A total of 32 instances of catastrophic breakage occurred. Each newly refurbished ureteroscope was used for an average of 6.9 times prior to incurring further catastrophic damage requiring repair. The disposable cost to the hospital for providing a flexible ureteroscope was $589.25 per case in this study, not including the cost of procuring the original inventory of 11 ureteroscopes. CONCLUSIONS Refurbished flexible ureteroscopes that have undergone comprehensive repair are extremely fragile in the setting of multiple surgeon users in a large public hospital that uses central processing for sterilization and storage. This poor durability results in significant maintenance, repair, and administrative inconvenience. Comparison of our results to literature precedent suggest that hospital costs can be reduced through procurement of quality scopes, adopting accountable cleaning and sterilization processes, and promoting safe physician handling and utilization of the ureteroscope. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e745-e746 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Robert Carey Sarasota, FL More articles by this author Christopher Martin Sarasota, FL More articles by this author Jacob Knego Sarasota, FL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...