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Title: An in vitro Comparative Assessment of Single-Use Flexible Ureteroscopes Using a Standardized Ureteroscopy Training Model
Authors: So, Wei Zheng
Gauhar, Vineet
Chen, Kelven
Lu, Jirong
Chua, Wei Jin 
Tiong, Ho Yee 
Keywords: Single-use flexible ureteroscope
Disposable ureteroscope
Reusable ureteroscope
Issue Date: 16-Jun-2022
Publisher: S. Karger AG
Citation: So, Wei Zheng, Gauhar, Vineet, Chen, Kelven, Lu, Jirong, Chua, Wei Jin, Tiong, Ho Yee (2022-06-16). An in vitro Comparative Assessment of Single-Use Flexible Ureteroscopes Using a Standardized Ureteroscopy Training Model. Urologia Internationalis. ScholarBank@NUS Repository.
Rights: Attribution-NonCommercial 4.0 International
Abstract: Introduction: Perceived benefits like decreased contamination rates and reduced postoperative incidence of complications after urolithiasis surgery have led to increased adoption of single-use flexible ureteroscopes (su-fURS). Using a validated, standardized simulator model with enhanced “fluoroscopic” capabilities, we performed an in vitro comparative assessment of four commercially available models of su-fURS. Both objective and subjective parameters were assessed in this study. Methods: Two standardized tasks, (1) exploration of the model’s kidney collecting system and (2) repositioning of a stone fragment from the upper renal to lower renal pole were assigned to participants, who performed these tasks on all four scopes. Four models of su-fURS (Boston LithoVue, PUSEN PU3033A, REDPINE, INNOVEX EU-ScopeTM) were assessed, with task timings as end-points for objective analysis. Cumulative “fluoroscopic” time was also recorded as a novel feature of our enhanced model. Post-task questionnaires evaluating specific components of the scopes were distributed to document subjective ratings. Results: Both subjective and objective performances (except stone repositioning time) across all four su-fURS demonstrated significant differences. However, objective performance (task timings) did not reflect subjective scope ratings by the participants (Rs < 0.6). Upon Kruskal-Wallis H test with post hoc analyses, REDPINE and INNOVEX EU-ScopeTM were the preferred su-fURS as rated by the participants, with overall scope scores of 9.00/10 and 9.57/10. Conclusions: Using a standardized in vitro simulation model with enhanced fluoroscopic capabilities, we demonstrated both objective and subjective differences between models of su-fURS. However, variations in perception of scope features (visibility, image quality, deflection, maneuverability, ease of stone retrieval) did not translate into actual technical performance. Eventually, the optimal choice of su-fURS fundamentally lies in individual surgeon preference, as well as cost-related factors.
Source Title: Urologia Internationalis
ISSN: 0042-1138
DOI: 10.1159/000525246
Rights: Attribution-NonCommercial 4.0 International
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