title: The new grasper-integrated single use flexible cystoscope for double J stent removal: evaluation of image quality, flow and flexibility.
abstract: BACKGROUND
  A new single use digital flexible cystoscope (FC) Isiris α from Coloplast®with an incorporated grasper has been developed to perform double J stent removal. There is a lack of data regarding the comparison of image quality, flexibility and flow between classic cystoscopes and the new Isiris α.
  
  
  METHODS
  Five different FC were used to compare the image quality, the field of view, the loss of flow and the deflection loss. Two standardized grids, three stones of different composition and a ruler's image were filmed in four standardized different scenarios. These videos were shown to thirty subjects that had to evaluate them. Water outflow was measured in ml/sec in all devices with and without the grasper inside, instruments tip deflection was measured using a software.
  
  
  RESULTS
  In the subjective analysis of the image quality Isiris α was the second FC best scored. At 3 cm of distance, the field view of Isiris α was the narrowest. Comparing the water flow in the different FCs, we observed a water flow decrease in all cystoscopes when the grasper was loaded in the working channel. Isiris α deflection and flow increase when the grasper is activated.
  
  
  CONCLUSIONS
  In terms of quality of vision and water flow, the FC Isiris α is comparable to the other digital FC tested. Field of view is narrower. The results displayed a valid alternative to the standard procedure for DJ removal.
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France. michele.talso@gmail.com.|Department of Urology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy. michele.talso@gmail.com.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-9925-2280
authors.initials: M
authors.lastname: Talso
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.|Department of Urology, Fundacion Puigvert Universitat Autonoma de Barcelona, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Emiliani
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Baghdadi
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Orosa
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Servian
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Barreiro
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Proietti
authors.affiliation: Department of Urology, Hôpital Tenon, Université Pierre et Marie Curie - Paris VI, 4 rue de la Chine, 75020, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Traxer
mesh_terms: D020684:Cystoscopes; D020878:Device Removal / Q000295:instrumentation*; D006801:Humans; D015607:Stents; D014513:Ureter
keywords: Cystoscopy; Disposable; Double J stent; Flexible cystoscope; Grasper; Isiris; New technology; Stent removal; Sterile; Stone