Locked Deflection During Flexible Ureteroscopy: Incidence and Elucidation of the Mechanism of an Underreported Complication

Journal of Endourology
Scott G HuboskyD H Bagley

Abstract

Flexible ureteroscopy (URS) is widely implemented with a well-defined safety profile and low complication rates. Although rare, locked deflection of a flexible ureteroscope in the upper tract is a potentially serious complication with poorly understood etiology and is likely underreported. We attempted to capture all cases of locked deflection during URS by performing an anonymous, online computer survey targeting members of the Endourological Society. The Manufacturer and User Facility Device Experience (MAUDE) database and published literature were queried to find additional cases. The indication for URS, method of ureteroscope removal, patient outcomes, incident reporting, and explanations provided by the manufacturer or third party repair service were obtained whenever possible. In total, 10 cases of locked deflection during flexible URS were identified. Survey responses were obtained from 250/2424 (10.3%) endourologists polled. Locked deflection was noted by 8/250 (3.2%). The reported literature and MAUDE database identified one case each. Successful removal was noted in four using retrograde manipulation techniques while a percutaneous approach was used in three patients. Open surgery was needed in two cases because of re...Continue Reading

References

Jan 1, 1967·The Journal of Urology·J B Hart
Dec 11, 2003·The Journal of Urology·J Kyle AndersonManoj Monga
Mar 26, 2004·The Urologic Clinics of North America·D Brooke Johnson, Margaret S Pearle
Mar 22, 2006·Journal of Endourology·Petrişor GeavleteVictor Cauni
Jul 22, 2011·Journal of Endourology·Michael OrdonR John D'A Honey
Oct 19, 2011·Journal of Endourology·Kelly A HealyDemetrius H Bagley

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Citations

Oct 29, 2015·Journal of Endourology·Ryuta TanimotoScott G Hubosky
Oct 31, 2017·Journal of Endourology Case Reports·Nariman GadzhievSergei Petrov
Jul 8, 2017·Journal of Endourology·Mattieu HaddadOlivier Traxer
Nov 22, 2019·World Journal of Urology·Vincent De ConinckOlivier Traxer
Oct 27, 2020·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Xiongpeng ShuLe Xie

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