Abstract
Objectives
A recently introduced device (LithoVue Empower™ or LE, Boston Scientifics, USA) allows the surgeon to directly control the stone-retrieving basket without the need of an assistant during flexible ureteroscopy. We aimed to evaluate the stone-retrieval performance of this device.
Methods
We used a bench-training model for flexible ureteroscopy, the Key-box (K-Box®, Porgès-Coloplast, France), to compare the LE configured with a 1.9F stone-retrieval tipless basket (ZeroTip™, Boston Scientific, USA) and a traditional assistant-maneuvered 1.9F stone-retrieval tipless basket. Seven experienced endo-urologists and seven residents-in-training retrieved a fake stone from three different renal cavities of the K-Box with increasing access complexity first with the traditional basket and then with the LE device. We recorded retrieval time and all the operators filled in the NASA Task Load Index (TLI) for the self-evaluation of their performance. We then compared the use of LE in terms of retrieval time, failure rates, and NASA-TLI scores.
Results
Stone retrieval times and failure rates were similar according to the retrieval technique, although residents had non-statistically significant shorter times with the LE. NASA-TLI scores revealed lower frustration (p = 0.03) when LE was used by experienced urologists as compared to the traditional basketing. When stratifying the analyses according to surgical experience, fully trained urologists performed faster stone retrieval and showed lower effort scores than residents-in-training (p < 0.05).
Conclusions
The individually controlled retrieval system is an effective device assisting stone retrieval and does not necessitate specific training among experienced endo-urologists. Young residents might benefit from LE during their learning curve.
Similar content being viewed by others
References
Somani BK, Ploumidis A, Pappas A, Doizi S, Babawale O, Dragos L et al (2019) Pictorial review of tips and tricks for ureteroscopy and stone treatment: an essential guide for urologists from PETRA research consortium. Transl Androl Urol 8:S371–S380. https://doi.org/10.21037/tau.2019.06.04
Doizi S, Traxer O (2018) Flexible ureteroscopy: technique, tips and tricks. Urolithiasis 46:47–58. https://doi.org/10.1007/s00240-017-1030-x
Türk C, Vice-chair AS, Neisius A, Petrik A, Seitz C, Thomas K, et al (2019) EAU Guidelines on Urolithiasis
EAU—European School of Urology. Endoscopic Stone Treatment (EST) n.d. https://uroweb.org/education/online-education/surgical-education/endoscopic-stone-treatment-est/ Accessed 1 Dec 2019
Ziemba JB, Matlaga BR (2016) Understanding the costs of flexible ureteroscopy. Minerva Urol Nefrol 68:586–591
Boston Scientific. Lithovue Empower—company data n.d. https://www.bostonscientific.com/en-US/products/retrieval-devices/lithovue-empower-retrieval-deployment-device.html. Accessed 1 Dec 2019
Villa L, Somani BK, Sener TE, Cloutier J, Cloutier J, Buttice S et al (2016) Comprehensive flexible ureteroscopy (FURS) simulator for training in endourology: the K-box model. Cent European J Urol 69:118–120. https://doi.org/10.5173/ceju.2016.710
Villa L, Şener TE, Somani BK, Cloutier J, Butticè S, Marson F et al (2017) Initial content validation results of a new simulation model for flexible ureteroscopy: the Key-Box. J Endourol 31:72–77. https://doi.org/10.1089/end.2016.0677
NASA. NASA Task Load Index (TLI) n.d. https://ntrs.nasa.gov/archive/nasa/casi.ntrs.nasa.gov/20000021488.pdf. Accessed 1 Dec 2019
Geraghty RM, Jones P, Herrmann TRW, Aboumarzouk O, Somani BK (2018) Ureteroscopy is more cost effective than shock wave lithotripsy for stone treatment: systematic review and meta-analysis. World J Urol 36:1783–1793. https://doi.org/10.1007/s00345-018-2320-9
Ventimiglia E, Somani BK, Traxer O (2019) Flexible ureteroscopy: reuse? Or is single use the new direction? Curr Opin Urol. https://doi.org/10.1097/MOU.0000000000000700
Talso M, Goumas IK, Kamphuis GM, Dragos L, Tefik T, Traxer O et al (2019) Reusable flexible ureterorenoscopes are more cost-effective than single-use scopes: results of a systematic review from PETRA Uro-group. Transl Androl Urol 8:S418–S425. https://doi.org/10.21037/tau.2019.06.13
Rukin NJ, Somani BK, Patterson J, Grey BR, Finch W, McClinton S et al (2015) Tips and tricks of ureteroscopy: consensus statement Part I. Basic ureteroscopy. Cent Eur J Urol 68:439–446. https://doi.org/10.5173/ceju.2015.605a
de la Rosette JJMCH, Skrekas T, Segura JW (2006) Handling and prevention of complications in stone basketing. Eur Urol 50:991–999. https://doi.org/10.1016/j.eururo.2006.02.033
Okada S, Hamamoto S, Inoue T, Minagawa S, Morikawa H, Matsuda T et al (2018) Development of the one-surgeon basketing technique in flexible ureteroscopy with laser lithotripsy for upper urinary tract calculi. Videourology. https://doi.org/10.1089/vid.2018.0005
Cracco CM, Scoffone CM (2011) ECIRS (Endoscopic Combined Intrarenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery? World J Urol 29:821–827. https://doi.org/10.1007/s00345-011-0790-0
Giusti G, Proietti S, Rodriguez-Socarras ME, Eisner BH, Saitta G, Mantica G et al (2018) Simultaneous bilateral endoscopic surgery (SBES) for patients with bilateral upper tract urolithiasis: technique and outcomes. Eur Urol 74:810–815. https://doi.org/10.1016/j.eururo.2018.06.034
Giusti G, Proietti S, Rodriguez-Socarras ME, Eisner BH (2019) Reply to Luca Boeri and Emanuele Montanari’s Letter to the Editor re: Guido Giusti, Silvia Proietti, Moises E. Rodriguez-Socarras, et al. Simultaneous Bilateral Endoscopic Surgery (SBES) for Patients with Bilateral Upper Tract Urolithiasis: Technique and Outcomes. Eur Urol 2018;74:810–5. Eur Urol 75:e173–4. 10.1016/j.eururo.2019.02.012
Dragos LB, Somani BK, Sener ET, Buttice S, Proietti S, Ploumidis A et al (2017) Which flexible ureteroscopes (Digital vs. Fiber-Optic) can easily reach the difficult lower pole calices and have better end-tip deflection. In vitro study on K-Box a PETRA evaluation. J Endourol 31:630–637. https://doi.org/10.1089/end.2017.0109
Proietti S, Dragos L, Emiliani E, Buttice S, Talso M, Baghdadi M et al (2017) Ureteroscopic skills with and without Roboflex Avicenna in the K-box((R)) simulator. Cent European J Urol 70:76–80. https://doi.org/10.5173/ceju.2017.1180
Villa L, Ventimiglia E, Proietti S, Giusti G, Briganti A, Salonia A et al (2019) Does working channel position influence the effectiveness of flexible ureteroscopy? Results from an in vitro study. BJU Int. https://doi.org/10.1111/bju.14923
Funding
None.
Author information
Authors and Affiliations
Contributions
EV, SD, and OT: Protocol/project development. SS, TB, FP, FQ, BD, AJG, YB, MACA, HK and LV: Data collection or management. Data analysis: EV, SS, and TB. EV, SS, TB, SD, BKS, and OT: Manuscript writing/editing.
Corresponding author
Ethics declarations
Conflict of interest
Prof. Olivier Traxer is a consultant for Coloplast, Rocamed, Olympus, EMS, Boston Scientific, and IPG.
Research involving human participants and/or animals
None.
Informed consent
Not applicable.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Ventimiglia, E., Sindhubodee, S., Besombes, T. et al. Operator-assisted vs self-achieved basketing during ureteroscopy: results from an in vitro preference study. World J Urol 39, 2169–2175 (2021). https://doi.org/10.1007/s00345-020-03431-5
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-020-03431-5