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MP50-07 COMPARISON OF PARAMETERS OF STANDARD REUSABLE


FLEXIBLE URETERO-RENOSCOPES WITH A SINGLE USE URETERO-
RENOSCOPE (LITHOVUE)

Article  in  The Journal of Urology · April 2017


DOI: 10.1016/j.juro.2017.02.1595

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Grzegorz Fojecki Nathan Lawrentschuk


University of Southern Denmark University of Melbourne
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Damien Bolton
University of Melbourne
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e686 THE JOURNAL OF UROLOGYâ Vol. 197, No. 4S, Supplement, Sunday, May 14, 2017

10 (18.9%) of patients had persistent hydronephrosis without evidence MP50-07


of obstruction on functional imaging. Four patients (7.5%) had persistent COMPARISON OF PARAMETERS OF STANDARD
hydronephrosis and some degree of obstruction on functional imaging. REUSABLE FLEXIBLE URETERO-RENOSCOPES WITH A
Univariate analysis found that an unsuccessful UAS placement was the SINGLE USE URETERO-RENOSCOPE (LITHOVUE)
only predictor for the development of post-operative hydronephrosis
Grzegorz Fojecki, Derek Hennessy, Nathan Lawrentschuk,
(28% vs 9.1%, p¼0.002)
Damien Bolton*, Melbourne, Australia
CONCLUSIONS: UAS use at the time of URSL was successful
in most patients and the risk of long-term obstruction is low. Post- INTRODUCTION AND OBJECTIVES: The new single use
operative hydronephrosis was observed in 10% of patients, however digital flexible ureteroscope (fURS), LithoVue is an evolution in digital
the majority of this hydronephrosis was mild and resolved without ureteroscope design. We aimed to assess the capability of this instru-
intervention. ment in-vivo and in-vitro, and to compare it to commonly used flexible
ureteroscopes in regard to these metrics and also its cost effectiveness
METHODS: An analysis of standard flexible ureteroscope
(Olympus URF-V) usage at our institution over 30 months was per-
formed for a cost analysis of fURS practice. The LithoVue was then
examined in-vitro for manoeuvrability and flow and compared to
Olympus URF-V and Stortz Flex Xc. Finally, LithoVue was used in 3
patients for the treatment of renal calculi. The single-use ureteroscope
(Lithovueâ, Boston Scientific) and two reusable scopes (URV-Fâ,
Olympus and Flex-Xcâ, Karl Storz) were assessed. Angulation and
irrigation fluid flow were examined first with an empty working channel
and than with various instruments engaged:

- hydrophilic guide wire


- hydrophilic tip wire
- laser fiber (200mm)
- basket (1.9Fr)
- biopsy forceps (3Fr)

RESULTS: With regard to cost analysis 265 fURS procedures


were performed over the study period. 20 instances of ureteroscope
damage occurred e classed as 15 major and 5 minor. Total cost of
repairs was $162,587 AUD. Including purchase price and repair costs,
mean cost per fURS case was $1883 AUD. In regard to performance
metrics, with an empty working channel the Lithuvue was superior to
both the URF-V and Flex Xc in terms of movement. Flexion of the
Lithovue is 285 , while the URF-V is 180 and the Flex Xc is 283 .
Deflection for the Lithovue is 286 , the URF-V is 270 and the Flex Xc
219 . Superiority of the Lithovue over the two other ureteroscopes was
maintained for movement in both directions with a variety of instruments
placed within the working channel. Finally, the LithoVue was demon-
strated to display satisfactory ergonomics, manoeuvrability and image
quality in the treatment of renal stones in 3 patientsInstruments
decreased the angulation range and fluid flow. However it was still
possible to bend tested devices to almost 180 degrees in every case,
which should be enough to reach all kidney calyxes. Furthermore there
were only slight differences in fluid flow in used scopes
CONCLUSIONS: This version of a single use disposable flex-
ible ureteroscope offers similar technical specifics to multiple use flex-
ible ureteroscopes in regard to range of flexion and extension, and also
in regard to fluid flow rates. It is likely to find utility in aspects of
endourologic practice depending upon pricing issues. Based on pur-
chase costs and rate of repair it may also represent a cost saving for
hospitals in regard to an amortised cost per case for this procedure.
Source of Funding: None

MP50-08
LIMITATIONS OF THE LITHOVUE SINGLE USE DIGITAL
FLEXIBLE URETEROSCOPE
Saum Ghodoussipour*, Eli Thompson, Adit Shah, Anirban Mitra,
Sameer Deshmukh, Matthew Dunn, Los Angeles, CA

INTRODUCTION AND OBJECTIVES: A new disposable flex-


ible digital ureteroscope (Lithovue, Boston Scientific, Marlborough,
Mass) was recently released as an alternative to nondisposable digital
Source of Funding: None
scopes. This series reviews our initial experience with this new device
with a focus on identifying its limitations.

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