title: Evaluation of a Novel Single-Use Flexible Ureteroscope.
abstract: Introduction:A novel single-use flexible ureteroscope promises the optical characteristics and maneuverability of a reusable fourth-generation flexible ureteroscope. In this study, the LithoVue Single-Use Digital flexible ureteroscope was directly compared with contemporary reusable flexible ureteroscopes, with regard to optics, deflection, and irrigation flow.Methods:Three flexible ureteroscopes such as the LithoVue (Single Use; Boston Scientific), Flex-Xc (Karl Storz, Germany), and Cobra (Richard Wolf, Germany) were assessedin vitrofor image resolution, distortion, color representation, grayscale imaging, field of view, and depth of field. Ureteroscope deflection was tested with an empty channel followed by placement of a 200 μm laser fiber and a 1.9F wire basket, a 2.0F nanoelectric pulse lithotripsy (NPL) probe, and a 2.4F NPL probe. Ureteroscope irrigation flow was measured using normal saline at 100 cm, with an empty channel followed by a 200 μm laser fiber, a 1.9F wire basket and a 2.0F NPL probe.Results:The LithoVue showed the largest field of view, with excellent resolution, image distortion, and depth of field. No substantial difference was demonstrated in color reproducibility or in the discernment of grayscales between ureteroscopes. The LithoVue maintained full deflection ability with all instruments in the working channel, although the Flex-Xc and Cobra ureteroscopes showed loss of deflection ranging from 2° to 27°, depending on the instrument placed. With an empty channel, the LithoVue showed an absolute flow rate similar to the Flex-Xc ureteroscope (p= 0.003). It maintained better flow with instruments in the channel than the Flex-Xc ureteroscope. The Cobra ureteroscope has a separate 3.3F instrument channel, keeping flow rates the same with instrument insertion.Conclusion:The LithoVue Single-Use Digital ureteroscope has comparable optical capabilities, deflection, and flow, making it a viable alternative to standard reusable fourth-generation flexible digital and fiberoptic ureteroscopes.
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Joanne
authors.initials: J
authors.lastname: Dale
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Adam G
authors.initials: AG
authors.lastname: Kaplan
authors.affiliation: Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina.
authors.forename: Daniela
authors.initials: D
authors.lastname: Radvak
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Richard
authors.initials: R
authors.lastname: Shin
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Anika
authors.initials: A
authors.lastname: Ackerman
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Tony
authors.initials: T
authors.lastname: Chen
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Scales
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Ferrandino
authors.affiliation: Department of Mechanical Engineering and Materials Science, Duke University, Durham, North Carolina.
authors.forename: Walter Neal
authors.initials: WN
authors.lastname: Simmons
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Glenn M
authors.initials: GM
authors.lastname: Preminger
authors.affiliation: Division of Urologic Surgery, Duke University, Durham, North Carolina.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Lipkin
mesh_terms: D004867:Equipment Design; D005858:Germany; D015203:Reproducibility of Results; D020709:Ureteroscopes; D018666:Ureteroscopy
keywords: LithoVue; fiberoptic; single-use; technology; ureteroscopy; urolithiasis