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Disposable devices for RIRS: Where do we stand in 2013? What do we need in the future?

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Abstract

Purpose

Disposable devices for retrograde intrarenal surgery (RIRS) form a significant part of the urologist’s armamentarium for the endoscopic management of urologic diseases. Herein, we provide an overview of the literature regarding the advances and controversies of these devices.

Methods

A PubMed search was used to identify the literature discussing the subject of disposable devices for RIRS. Articles published between 2012 and 2013 were considered.

Results

Ureteral access implements including access sheaths, wires, and dilators are an area of both improvement and controversy regarding their proper use. The safety, effectiveness, and limitations of lithotrites continue to be refined. Stone retrieval devices are undergoing persistent miniaturization, and their use may prove to be cost effective. The debate over perioperative stenting remains, while symptom management is explored. A cost-effective option for disposable flexible ureteroscopy shows promise.

Conclusions

While rapid advances in technology and knowledge continue, continual improvements are necessary. Disposable equipment needs persistent refinement and possible miniaturization. More efficient fragment retrieval devices are needed. Durability of laser fibers and safety within ureteroscopes needs to be improved. Reducing stent morbidity remains an ongoing challenge. Lastly, costs need to be reduced by the further development of disposable flexible ureteroscopes and in the recyclability of disposable devices to improve availability worldwide.

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References

  1. Rizkala ER, Monga M (2013) Controversies in ureteroscopy: wire, basket, and sheath. Indian J Urol 29(3):244–248

    Article  PubMed Central  PubMed  Google Scholar 

  2. Kourambas J, Byrne RR, Preminger GM (2001) Does a ureteral access sheath facilitate ureteroscopy? J Urol 165(3):789–793

    Article  CAS  PubMed  Google Scholar 

  3. Traxer O, Thomas A (2013) Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol 189(2):580–584

    Article  PubMed  Google Scholar 

  4. Delvecchio FC et al (2003) Assessment of stricture formation with the ureteral access sheath. Urology 61(3): 518–522; discussion 522

  5. Bach C et al (2012) The new digital flexible ureteroscopes: ‘size does matter’–increased ureteric access sheath use! Urol Int 89(4):408–411

    Article  CAS  PubMed  Google Scholar 

  6. Ayyathurai R et al (2012) Single-center clinical comparison of two reinforced ureteral access sheaths for retrograde ureteroscopic treatment of urinary lithiasis. Int Urol Nephrol 44(2):409–414

    Article  PubMed  Google Scholar 

  7. Kawahara T et al (2012) Preoperative stenting for ureteroscopic lithotripsy for a large renal stone. Int J Urol 19(9):881–885

    Article  PubMed  Google Scholar 

  8. Berquet G et al (2013) The use of a ureteral access sheath does not improve stone-free rate after ureteroscopy for upper urinary tract stones. World J Urol 32(1):229–232

    Article  PubMed  Google Scholar 

  9. Doizi S et al (2013) First clinical evaluation of a new innovative ureteral access sheath (Re-Trace): a European study. World J Urol 32(1):143–147

    Article  PubMed  Google Scholar 

  10. Sarkissian C et al (2012) Systematic evaluation of hybrid guidewires: shaft stiffness, lubricity, and tip configuration. Urology 79(3):513–517

    Article  PubMed  Google Scholar 

  11. Ulvik O, Wentzel-Larsen T, Ulvik NM (2013) A safety guidewire influences the pushing and pulling forces needed to move the ureteroscope in the ureter: a clinical randomized, crossover study. J Endourol 27(7):850–855

    Article  PubMed  Google Scholar 

  12. Bourdoumis A et al (2013) The difficult ureter: stent and come back or balloon dilate and proceed with ureteroscopy? What does the evidence say? Urology 83(1):1–3

    Article  PubMed  Google Scholar 

  13. Kuntz N et al (2013) Balloon dilation of the ureter: a contemporary review of outcomes and complications. J Endourol 27:A402

    Article  Google Scholar 

  14. Hendlin K et al (2012) Systematic evaluation of a novel foot-pump ureteroscopic irrigation system. J Endourol 26(2):126–129

    Article  PubMed  Google Scholar 

  15. Hendlin K, Weiland D, Monga M (2008) Impact of irrigation systems on stone migration. J Endourol 22(3):453–458

    Article  PubMed  Google Scholar 

  16. Wiener SV, Deters LA, Pais VM Jr (2012) Effect of stone composition on operative time during ureteroscopic holmium:yttrium-aluminum-garnet laser lithotripsy with active fragment retrieval. Urology 80(4):790–794

    Article  PubMed  Google Scholar 

  17. Khemees TA et al (2013) Evaluation of a new 240-mum single-use holmium:yAG optical fiber for flexible ureteroscopy. J Endourol 27(4):475–479

    Article  PubMed  Google Scholar 

  18. Magheli A et al (2012) Critical analysis of the miniaturized stone basket: effect on deflection and flow rate. J Endourol 26(3):275–277

    Article  PubMed  Google Scholar 

  19. Bedke J et al (2013) 1.2 French stone retrieval baskets further enhance irrigation flow in flexible ureterorenoscopy. Urolithiasis 41(2):153–157

    Article  PubMed  Google Scholar 

  20. Cordes J et al (2013) Damage of stone baskets by endourologic lithotripters: a laboratory study of 5 lithotripters and 4 basket types. Adv Urol 2013:632790

    Article  PubMed Central  PubMed  Google Scholar 

  21. Sarkissian C, Marchini GS, Monga M (2013) Endoscopic forceps for ureteroscopy: a comparative in vitro analysis. Urology 81(3):690–695

    Article  PubMed  Google Scholar 

  22. Wason SE et al (2012) Ureteroscopic biopsy of upper tract urothelial carcinoma using a novel ureteroscopic biopsy forceps. Can J Urol 19(6):6560–6565

    PubMed  Google Scholar 

  23. Netsch C et al (2012) Impact of preoperative ureteral stenting on stone-free rates of ureteroscopy for nephroureterolithiasis: a matched-paired analysis of 286 patients. Urology 80(6):1214–1219

    Article  PubMed  Google Scholar 

  24. Silay MS, Tanriverdi O, Miroglu C (2012) Re: Preoperative stenting decreases operative time and reoperative rates of ureteroscopy (from: Chu L, Sternberg KM, Averch TD. Preoperative stenting decreases operative time and reoperative rates of ureteroscopy. J Endourol 2011;25:751–754). J Endourol 26(1):75–76

  25. Hughes B et al (2013) The dilemma of post-ureteroscopy stenting. BJU Int 113(2):184–185

    Article  Google Scholar 

  26. Song T et al (2012) Meta-analysis of postoperatively stenting or not in patients underwent ureteroscopic lithotripsy. Urol Res 40(1):67–77

    Article  PubMed  Google Scholar 

  27. Torricelli FC et al (2013) Flexible ureteroscopy with a ureteral access sheath: when to stent? Urology 83(2):278–281

    Article  PubMed  Google Scholar 

  28. Matani YS et al (2013) Emergency double-J stent insertion following uncomplicated Ureteroscopy: risk-factor analysis and recommendations. Int Braz J Urol 39(2):203–208

    PubMed  Google Scholar 

  29. Shigemura K et al (2012) How long should double J stent be kept in after ureteroscopic lithotripsy? Urol Res 40(4):373–376

    Article  PubMed  Google Scholar 

  30. Ozgur BC et al (2013) Bacterial colonization of double J stents and bacteriuria frequency. Kaohsiung J Med Sci 29(12):658–661

    Article  PubMed  Google Scholar 

  31. Nazim SM, Ather MH (2012) Alpha-blockers impact stent-related symptoms: a randomized, double-blind, placebo-controlled trial. J Endourol 26(9):1237–1241

    Article  PubMed  Google Scholar 

  32. Kawahara T et al (2012) Changing to a loop-type ureteral stent decreases patients’ stent-related symptoms. Urol Res 40(6):763–767

    Article  PubMed  Google Scholar 

  33. Tadros NN et al (2013) A single dose of a non-steroidal anti-inflammatory drug (NSAID) prevents severe pain after ureteric stent removal: a prospective, randomised, double-blind, placebo-controlled trial. BJU Int 111(1):101–105

    Article  CAS  PubMed  Google Scholar 

  34. Bresalier RS et al (2005) Cardiovascular events associated with rofecoxib in a colorectal adenoma chemoprevention trial. N Engl J Med 352(11):1092–1102

    Article  CAS  PubMed  Google Scholar 

  35. Johnson MT, Khemees TA, Knudsen BE (2013) Resilience of disposable endoscope optical fiber properties after repeat sterilization. J Endourol 27(1):71–74

    Article  PubMed  Google Scholar 

  36. Gu SP et al (2013) Clinical effectiveness of the PolyScope endoscope system combined with holmium laser lithotripsy in the treatment of upper urinary calculi with a diameter of less than 2 cm. Exp Ther Med 6(2):591–595

    PubMed Central  PubMed  Google Scholar 

  37. Palmero JL et al (2013) Results of retrograde intrarenal surgery in the treatment of renal stones greater than 2 cm. Actas Urol Esp 38(4):257–262

    PubMed  Google Scholar 

  38. Gurbuz C et al (2013) The cost analysis of flexible ureteroscopic lithotripsy in 302 cases. Urolithiasis 42(2):155–158

    Article  PubMed  Google Scholar 

  39. Maeda JL, Raetzman SO, Friedman BS (2012) What hospital inpatient services contributed the most to the 2001–2006 growth in the cost per case? Health Serv Res 47(5):1814–1835

    Article  PubMed Central  PubMed  Google Scholar 

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Conflict of interest

Dr. Michael Lipkin is a consultant for Boston Scientific and a speaker for Lumenis. Dr. Glenn Preminger is a consultant for Boston Scientific and Olympus.

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The manuscript does not contain clinical studies or patient data.

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Authors and Affiliations

  1. Division of Urologic Surgery, Comprehensive Kidney Stone Center, Duke University Medical Center, Room 1573 White Zone, Box 3167, Durham, NC, 27710, USA

    Richard H. Shin, Michael E. Lipkin & Glenn M. Preminger

Authors
  1. Richard H. Shin
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  2. Michael E. Lipkin
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  3. Glenn M. Preminger
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Correspondence to Glenn M. Preminger.

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Shin, R.H., Lipkin, M.E. & Preminger, G.M. Disposable devices for RIRS: Where do we stand in 2013? What do we need in the future?. World J Urol 33, 241–246 (2015). https://doi.org/10.1007/s00345-014-1368-4

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  • DOI: https://doi.org/10.1007/s00345-014-1368-4

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