PD22-10 DURABILITY OF FLEXIBLE URETEROSCOPES: A PROSPECTIVE STUDY ON LONGEVITY AND AFFECTING FACTORS

Abstract

You have accessJournal of UrologySurgical Technology & Simulation: Instrumentation & Technology II1 Apr 2018PD22-10 DURABILITY OF FLEXIBLE URETEROSCOPES: A PROSPECTIVE STUDY ON LONGEVITY AND AFFECTING FACTORS Jaap Legemate, Guido Kamphuis, Jan Erik Freund, Joyce Baard, Stefano Zanetti, Michele Catellani, Harry Oussoren, and Jean de la Rosette Jaap LegemateJaap Legemate More articles by this author , Guido KamphuisGuido Kamphuis More articles by this author , Jan Erik FreundJan Erik Freund More articles by this author , Joyce BaardJoyce Baard More articles by this author , Stefano ZanettiStefano Zanetti More articles by this author , Michele CatellaniMichele Catellani More articles by this author , Harry OussorenHarry Oussoren More articles by this author , and Jean de la RosetteJean de la Rosette More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.1178AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Optimizing the durability of reusable flexible scopes is important for the economic sustainability of endourology. This study evaluates the durability of the latest digital and fiberoptic reusable flexible ureteroscopes. Moreover, factors that may affect the durability are assessed. These outcomes will contribute to the maximization of ureteroscope durability and thereby reduce costs. METHODS Two digital Olympus URF V2 scopes, two digital Karl Storz Flex Xc scopes, one fiberoptic Olympus URF P6 scope and one fiberoptic Karl Storz Flex X2 scope were included. The primary endpoint for each scope was its first repair. Data on treatment characteristics, accessory device use, image quality, scope handling, type of damage and number of high-level disinfection cycles were collected prospectively for every procedure. After every procedure maximal ventral and dorsal scope deflection were documented on digital images. Scope durability was measured as the total number of uses and ureteroscopy time. RESULTS A total of 198 procedures were performed. The average total number of procedures for digital scopes was 37 (19h57min) and for fiberoptic scopes 23.5 (11h34min). Image quality remained high throughout the study for all scopes. The ease of scope handling and the range of deflection remained good under incremental use. Changes in scope deflection are presented in figure 1. Damage of the distal part of the shaft and shaft coating were the most frequent reasons for repair and were related to intraoperative manual forcing. In 52 (27%) of all procedures manual forcing of the scope was reported. Manual forcing was reported in 8 (57%) of the procedures in cases with a deviant anatomy, 15 (40%) of the procedures with stones > 80 mm2, 12 (38%) of the procedures longer than 60 minutes and 14 (27%) of the lower pole pathology procedures. Expiration of the disinfection shelf life before use resulted in a 1.8 times higher number of disinfection cycles than number of uses. CONCLUSIONS Damage of the flexible shaft is the most important limitation to the durability of ureteroscopes. Prevention of intraoperative manual forcing of flexible ureteroscopes maximizes their durability. Attention to the scopes disinfection expiration date can reduce the number of disinfection cycles. This may aid scope durability and reduce costs. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e478 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Jaap Legemate More articles by this author Guido Kamphuis More articles by this author Jan Erik Freund More articles by this author Joyce Baard More articles by this author Stefano Zanetti More articles by this author Michele Catellani More articles by this author Harry Oussoren More articles by this author Jean de la Rosette More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...