MP55-17 NEW CONCEPTION FOR FLEXOR VUE DEFLECTING ENDOSCOPIC SYSTEM USE, IN ORDER TO IMPROVE STONE FREE RATE (SFR) AFTER RIRS: PRELIMINARY RESULTS FROM A SINGLE CENTRE STAGE 2A STUDY

Abstract

You have accessJournal of UrologyStone Disease: Surgical Therapy II1 Apr 2018MP55-17 NEW CONCEPTION FOR FLEXOR VUE DEFLECTING ENDOSCOPIC SYSTEM USE, IN ORDER TO IMPROVE STONE FREE RATE (SFR) AFTER RIRS: PRELIMINARY RESULTS FROM A SINGLE CENTRE STAGE 2A STUDY Alberto Saita, Paolo Casale, Massimo Lazzeri, NicolòMaria Buffi, Rodolfo Hurle, Roberto Peschechera, Giovanni Lughezzani, Alessio Benetti, Luisa Pasini, Silvia Zandegiacomo, Giuliana Lista, Pasquale Cardone, and Giorgio Guazzoni Alberto SaitaAlberto Saita More articles by this author , Paolo CasalePaolo Casale More articles by this author , Massimo LazzeriMassimo Lazzeri More articles by this author , NicolòMaria BuffiNicolòMaria Buffi More articles by this author , Rodolfo HurleRodolfo Hurle More articles by this author , Roberto PeschecheraRoberto Peschechera More articles by this author , Giovanni LughezzaniGiovanni Lughezzani More articles by this author , Alessio BenettiAlessio Benetti More articles by this author , Luisa PasiniLuisa Pasini More articles by this author , Silvia ZandegiacomoSilvia Zandegiacomo More articles by this author , Giuliana ListaGiuliana Lista More articles by this author , Pasquale CardonePasquale Cardone More articles by this author , and Giorgio GuazzoniGiorgio Guazzoni More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1788AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Stone extraction devices have become a routine tool after RIRS. Perforation and avulsion of the ureter wall, due to excessive force on the extraction device, are serious complications of basketing. Furthermore timing of basketing may have a significant impact on procedure total time. We tested the hypothesis that the use of Flexor Vue Deflecting Endoscopic System used as ureteral access sheath (UAS) may increase the SFR after RIRS thanks to the Bernulli's principle. METHODS This is a prospective, observational, single-center stage 2a study with data collected on consecutive patients treated for renal stones. Patients 18 year-old or older, candidates for RIRS of medium size (1.5-2.5 cm) renal stones as primary treatment or after failed previous treatment were cases of interest. Patients with multiple stones were excluded from study. All the procedures were performed using a 200 μm holmium fiber using a flexible ureterorenoscope and standard UAS. The Flexor Vue Deflecting Endoscopic System was positioned at the end of procedure in order to avoid basketing and improve SFR. The outcomes of interest are feasibility, safety and efficacy. Feasibility was defined as the capacity of positioning and favouring fragment removal according to the Bernulli's principle by the Flexor device. Safety was defined by complication analysis. Efficacy outcomes measured operative time, SFR, hospital stay, re-treatment and rehospitalization. SFR was defined as fragments less than 4 mm assessed by ultrasound and CT. Descriptive statistical analysis was applied. RESULTS 11 patients (M/F ratio: 7/4, mean age 63.5 ± 8.3) were treated. The stones were located in the lower calyces, and the renal pelvis in 3 and 8 patients, respectively. Medium stone size was 1.8 mm ± 3.2. The procedure with Flexor Vue Deflecting Endoscopic System was feasible in all the patients. Eight patients underwent preoperative ureteral stent. Mean operative time was 82 min ± 13.7 and median hospital stay was of 1.5 day. During the procedure the video channel was used as irrigating channel in order to favour fragment evacuation according to Bernoulli's principle. The SFR after 30 days was 81% (9/11). Post-operatively we had no significant bleeding, 1 patient with fever, who required antibiotic treatment for 5 days and no sepsis. No cost/effectiveness study was performed CONCLUSIONS The use of Flexor Vue Deflecting Endoscopic System seems to be feasible, safe and effective for patients with medium size (1.5 to 2.5 cm) renal stones. The technique we described could allow an easy non-invasive procedure for fragments evacuation. Further studies with larger population and under randomised setting, comparing with traditional flexible RIRS, are mandatory before the introduction of this technique in our clinical practice. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e754 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Alberto Saita More articles by this author Paolo Casale More articles by this author Massimo Lazzeri More articles by this author NicolòMaria Buffi More articles by this author Rodolfo Hurle More articles by this author Roberto Peschechera More articles by this author Giovanni Lughezzani More articles by this author Alessio Benetti More articles by this author Luisa Pasini More articles by this author Silvia Zandegiacomo More articles by this author Giuliana Lista More articles by this author Pasquale Cardone More articles by this author Giorgio Guazzoni More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...