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Simplified scoring systems to rank end-tip deflection of flexible ureteroscopes

By: Dragoş L.B.1, Somani B.K.2, Sener T.E.3, Buttice S.4, Proietti S.5, Minciu R.T.1, Pupca G.N.1, Botoca M.1, Doizi S.6, Traxer O.7
Institutes: 1University of Medicine and Pharmacy "Victor Babes" Timisoara, Dept. of Urology, Timişoara, Romania, 2University Hospital Southampton NHS Trust, Dept. of Urology, Southampton, United Kingdom, 3Marmara University, Dept. of Urology, Istanbul, Turkey, 4Universita Degli Studi Di Messina, Dept. of Urology, Messina, Italy, 5Ospedale San Raffaele, Dept. of Urology, Milan, Italy, 6Hopital Tenon, Dept. of Urology, Paris, France, 7Hopital Tenon, Universite Pierre Et Marie Curie - Paris VI, Dept. of Urology, Paris, France

Introduction & Objectives

As flexible ureteroscopes (fURSs) have evolved over a period of time, one of the limiting factors for calyceal/stone access is the end-tip deflection of different fURSs. We wanted to develop a simplified scoring system to rank end-tip deflection of the commonly used fURSs.

Material & Methods

Nine commonly used fURSs (BOA vision, COBRA vision, R.Wolf; FLEX X2, FLEX Xc, K.Storz; LithoVue, Boston Scientific; URF- P5, URF-P6, URF-V, URF-V2, Olympus) were tested for their end-tip deflection by a team of independent endourologists. Passing the fURSs through a 10/12Fr (12/14Fr for COBRA vision) ureteral access sheath (ReTrace, Porgès-Coloplast), the maximum end-tip deflection for every fURS was measured with the tip extended out from the sheath at 1 cm, 2 cm, 3 cm and 4 cm. First scoring method (SM-1) relied on scoring these nine fURSs from 1-9 for each of the distal 4 centimetres, wherein the sum-total of all scores (at point 1cm, 2cm, 3cm and 4cm) were added to give a final score (Table 1). The second scoring method (SM-2) relied on scoring the fURSs for end tip deflection for each of the distal 4 centimetres, wherein the sum-total of all scores (degrees of deflection at point 1cm, 2cm, 3cm and 4cm) were added to give a final score (Table 2).

Results

All fURSs were ranked twice based on both these scoring systems (Table 3). While 5 fURSs had exactly the same ranking based on the scores achieved, 4 other fURSs were ranked slightly differently with the difference being a maximum of one rank only. While FLEX X2, URF-P6, COBRA vison, URF-V and URF-V2 ranked 1st, 4th, 7th, 8th and 9th respectively in both scoring systems; FLEX Xc and URF-P5 ranked 2nd/3rd and 3rd/2nd respectively based on the scoring systems; and BOA vison and LithoVue ranked 5th/6th and 6th/5th respectively based on the scoring systems.

Conclusions

Our scoring systems for end-tip-deflection of fURSs are an easy and convenient way to rank existing and new fURSs. This might not only have an effect on development of new products/fURSs but also help in the decision making for endourologists interested in buying new fURSs.

  • Event: 4th Meeting of the EAU Section of Urolithiasis (EULIS)
  • Type: Abstract
  • Date: 06-10-2017
  • Views: 76
  • Nr: 126
  • Session: Unmoderated Poster Session
  • Location: Friday 6 October 2017, 13:00 - 13:30, Foyer Stolz & Lehar