Ureteroscopy for stone treatment using new 270 degrees semiflexible endoscope: in vitro, ex vivo, and clinical application

Journal of Endourology
Gunnar Wendt-NordahlThomas Knoll

Abstract

The use of flexible ureteroscopy for diagnosis and management of upper urinary tract diseases is limited both by loss of maximum active deflection through the inserted working probes and a high frequency of damage with consequent costs. A newly developed ureteroscope (Flex-X, Karl Storz) with a maximized angle of deflection was introduced to overcome these problems. The aim of our study was to compare this new ureteroscope with an established device in vitro, ex vivo, and in a clinical approach. Angles of maximum active deflection and maximum irrigation flow were measured for both scopes in vitro with an empty working channel and after introduction of different lithotripsy and stone extraction probes. In addition, the loss of maximum active deflection and broken optical fibers of the scopes were assessed after 100 flexible ureteroscopies in an ex-vivo pig cadaver model. The clinical performance of both ureteroscopes was evaluated in 32 patients for management of lower pole stones. The new ureteroscope displays highly improved deflection compared with the standard scope; deflection angles as much as 270 degrees with an empty working channel were achieved. Thin probes did not inhibit maximum deflection. Durability in ex vivotrial...Continue Reading

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Citations

Apr 23, 2008·Der Urologe. Ausg. A·P HoneckM S Michel
Jul 19, 2013·Der Urologe. Ausg. A·C Netsch, A J Gross
Nov 1, 2011·World Journal of Urology·Thomas KnollGunnar Wendt-Nordahl
Jun 21, 2011·Journal of Endourology·Christopher NetschThorsten Bach
Sep 15, 2012·Journal of Endourology·Abdullah ArmaganSinasi Yavuz Onol
May 27, 2009·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Hemendra Navinchandra Shah
Jan 22, 2014·Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a·Chunsheng LiZhijun Min
Feb 6, 2014·Indian Journal of Urology : IJU : Journal of the Urological Society of India·Andreas J GrossChristopher Netsch
Mar 6, 2012·Journal of Medical Engineering & Technology·G J J WarmerdamP F F Wijn
Dec 16, 2016·Advances in Urology·Joan C DeltoAlan M Nieder

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