Comparison of tipless and helical baskets in an in vitro ureteral model

Abstract

Objectives To compare the rapidity of stone capture and removal by six tipless and four helical baskets in a ureteral model. Expeditious ureteral stone extraction is reliant on the basket size, configuration, and radial dilation force. Methods A 5-mm feline calculus was placed in a simulated model of the human ureter at a distance of 7.5 cm from the orifice, and saline irrigant instilled. A 6/7.5F Wolf semirigid ureteroscope was used for access and visualization of the stone. Operators were randomized to start stone extraction with 1 of 10 stone baskets, and three extraction attempts were conducted with each device. Six experienced operators tested each device. The tipless baskets tested were the ACMI Sur-Catch NT 3.0F, Bard Dimension 3.0F, Boston Scientific Zerotip 3.0F, Cook N-Circle 3.0F, Cook Delta 2.4F, and Sacred Heart Halo 1.9F. The helical baskets tested were the Cook N-Force 3.2F, Microvasive Gemini 3.0F, ACMI Sur-Catch Helical 3.0F, and Sacred Heart Hercules 3.0F. The time to extraction in seconds was recorded. Results No statistically significant difference was observed between the tipless (14 ± 7 seconds) or helical (12.8 ± 6.6 seconds, P = 0.21) basket groups. All baskets were able to retrieve the ureteral stones successfully. The most efficient basket was the Cook N-Circle with an average time of 8.7 seconds to stone extraction compared with the least efficient basket, the ACMI Sur-Catch NT, at 15.8 seconds. Conclusions The Cook N-Circle basket provided the most expeditious means to stone extraction in a ureteral model.