MP26-17 THE ZIZO ADAPTER: A NOVEL URETEROSCOPE ADAPTER TO IMPROVE SURGICAL FIELD STERILITY AND PROTECT SURGICAL STAFF FROM BIOHAZARD JETS

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP26-17 THE ZIZO ADAPTER: A NOVEL URETEROSCOPE ADAPTER TO IMPROVE SURGICAL FIELD STERILITY AND PROTECT SURGICAL STAFF FROM BIOHAZARD JETS Zizo Al-Daqqaq, Monica Farcas, Kai Fok, and Samir Sami Zizo Al-DaqqaqZizo Al-Daqqaq More articles by this author , Monica FarcasMonica Farcas More articles by this author , Kai FokKai Fok More articles by this author , and Samir SamiSamir Sami More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003254.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroscopy and laser lithotripsy is performed under pressurized irrigation using a ureteroscope adapter for entry and manipulation of fine surgical tools such as laser fibres and nitinol baskets, as well as leak prevention during manipulation. Problems with current adapters include frequent jet-leaks of biohazardous fluids towards medical staff and patients, damage to the adapter from overtightening to stop leaks, and unintended adapter-scope disconnections. Our objective was to develop a novel ureteroscope adapter that eliminates the shortcomings of the market adapters while improving safety and ergonomics. METHODS: A patent and device search was completed to ensure there were no existing alternatives on the market. A literature search followed to confirm that ureteroscopy and laser lithotropsy was the most common laser urology procedure in North America, supporting the need for a safer ureteroscope adapter. Over 15 adapter prototype iterations underwent benchtop testing that mimics operative conditions for ureteroscopy, including appropriate irrigation pressures and realistic tool manipulation. Rigorous tests were performed in excess of typical ureteroscopy cases. This included 100 tool insertions and removals of fine tools like laser fibres and larger 5 French biopsy forceps, accidental disconnection tests, leak tests, and ergonomics assessments. RESULTS: The Zizo adapter was evaluated on frequency of jet leaks, accidental disconnections, and ergonomics, with expert feedback from endo-urologic surgeons. The unique design of the Zizo adapter eliminated 100% of jet-leaks at irrigation pressures exceeding 400mmHg, 100mmHg greater than the typical irrigation pressure during ureteroscopy cases. Jet-leak prevention was sustained with repeated passage of tools such as the holmium laser fibre, both 200 and 365 micron, nitinol baskets, and with larger instruments such as the 5 french biopsy forceps. The Zizo Adapter and its self-sealing valve has improved ergonomics, eliminates biohazardous jet-leaks, and delicately holds surgical tools in place. CONCLUSIONS: The Zizo Adapter is a safe and effective alternative to current ureteroscopy market adapters. The adapter has the potential to improve patient and provider safety, facilitates ease with which ureteroscopy is performed, and saves healthcare dollars by reducing tool damage and costs associated with managing biohazardous leaks. Source of Funding: N/A © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e360 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zizo Al-Daqqaq More articles by this author Monica Farcas More articles by this author Kai Fok More articles by this author Samir Sami More articles by this author Expand All Advertisement PDF downloadLoading ...