Prospective evaluation of refurbished flexible ureteroscope durability seen in a large public tertiary care center with multiple surgeons.
OBJECTIVE
To evaluate the durability and cost of maintenance for outsourced, refurbished flexible ureteroscopes.


METHODS
Ureteroscope usage and repair were prospectively recorded over a 365-day period at a large 836-bed public hospital. Cases were performed by 14 different urologists using either refurbished DUR-8 or DUR-8 Elite model ureteroscopes. Retrograde cases involving calculi, urothelial carcinoma, stricture, and diagnostic evaluations were included. Ureteroscope repairs were performed by a single outsourced repair vendor, not the original manufacturer.


RESULTS
A total of 501 ureteroscopic cases involving 550 ureteroscope usages were performed over a 365-day period. Semirigid ureteroscopes were used for 281 (56.1%) cases and refurbished flexible ureteroscopes for 220 (43.9%). The reason for the ureteroscopy was calculi in 386 (77.0%) cases, urothelial carcinoma in 32 (6.4%), stricture in 36 (7.2%), and diagnostic in 47 (9.4%). No repairs were needed during this period for semirigid scopes. Ureteral access sheaths were used in 82 (37.7%) of the cases. A total of 32 instances of catastrophic breakage occurred. Each newly refurbished ureteroscope was used for an average of 6.9 times before incurring further damage requiring repair.


CONCLUSIONS
Refurbished flexible ureteroscopes that have undergone comprehensive repair are extremely fragile in the setting of multiple surgeon users in a large public hospital that uses central processing for sterilization and storage. This poor durability results in significant maintenance, repair, and administrative inconvenience that should be considered along with the purchase price.
Florida State University College of Medicine, Sarasota, FL. Electronic address: ricarey@juno.com.
Robert I
RI
Carey
Florida State University College of Medicine, Sarasota, FL.
Christopher J
CJ
Martin
Florida State University College of Medicine, Sarasota, FL.
Jacob R
JR
Knego
D003365:Costs and Cost Analysis; D004867:Equipment Design; D017743:Equipment Reuse / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D008283:Maintenance / Q000191:economics / Q000706:statistics & numerical data; D011446:Prospective Studies; D062606:Tertiary Care Centers; D013997:Time Factors; D020709:Ureteroscopes / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D013520:Urologic Surgical Procedures / Q000295:instrumentation; D014572:Urology