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The new concept of ureteral access sheath with guidewire disengagement: One wire does it all

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Abstract

Purpose

To prospectively evaluate the new Flexor©Parallel™ Rapid Release™ (Cook®, Bloomington, IN, USA) access sheath (UAS) which allows the use of a single wire to serve as both safety and working guide.

Materials and methods

Between June and September 2014, adult patients from five European centers who underwent flexible ureteroscopy (fURS) for therapeutic and diagnostic purposes were included. The 12/14Fr Flexor©Parallel™ UAS was evaluated. Data were collected and examined by both univariate and multivariate analyses. The UAS material and usage characteristics were rated per case by the surgeons on a scale from very bad to very good.

Results

In total, 134 UASs were used in 67 male and 67 female patients. Fifty percent of ureters (67 patients) were pre-stented. Ninety percent of the procedures were therapeutic. The overall successful insertion rate was 94 %. Pre-stenting status was the only independent factor for a successful access sheath insertion: 98.5 % of the pre-stented patients had a successful UAS placement vs. 82 % of non-pre-stented (p = 0.001, C.I. 95 %: 1.2). Evaluation of the material and radiopacity was considered very good in over 90 % of cases. Release of the guidewire, hydrophilic coating, gliding of the endoscope and repeatability were considered very good in over 80 %. There were two (1.4 %) UAS malfunctions and one submucosal lesion reported.

Conclusions

The use of the Flexor©Parallel™ Rapid Release™ (Cook®, Bloomington, IN, USA) with usage of a single guidewire in a prospective multicentric scenario was clinically applicable in the majority of cases. Pre-stenting increased the chance of a successful insertion from 82 to 98.5 %.

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References

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

    Article  CAS  PubMed  Google Scholar 

  2. Auge BK, Pietrow PK, Lallas CD et al (2001) Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol 18:33–36

    Article  Google Scholar 

  3. Stern JM, Yiee J, Park S (2007) Safety and efficacy of ureteral access sheaths. J Endourol 21:119–123

    Article  PubMed  Google Scholar 

  4. Lallas CD, Auge BK, Raj GV et al (2002) Laser Doppler flowmetric determination of ureteral blood flow after ureteral access sheath placement. J Endourol 16:583

    Article  PubMed  Google Scholar 

  5. Türk C, Knoll T, Petrik A et al (2015) EAU guidelines on urolithiasis. Uroweb. http://www.uroweb.org/gls/pdf/22%20Urolithiasis_LR.pdf. Accessed 9 Feb 2015

  6. Stern JM, Yiee J, Park S (2007) Safety and efficacy of ureteral access sheaths. J Endourol 21:119–123

    Article  PubMed  Google Scholar 

  7. 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 189:580–584

    Article  PubMed  Google Scholar 

  8. Bourdoumis A, Tanabalan C, Goyal A et al (2014) The difficult ureter: stent and come back or balloon dilate and proceed with ureteroscopy? What does the evidence say? Urology 83:1–3

    Article  PubMed  Google Scholar 

  9. Ambani SN, Faerber GJ, Roberts WW, Hollingsworth JM, Wolf JS Jr (2013) Ureteral stents for impassable ureteroscopy. J Endourol 27:549–553

    Article  PubMed  Google Scholar 

  10. Mogilevkin Y, Sofer M, Margel D et al (2014) Predicting an effective ureteral access sheath insertion: a bicenter prospective study. J Endourol 28:1414–1417

    Article  PubMed  Google Scholar 

  11. Doizi S, Knoll T, Scoffone CM et al (2014) First clinical evaluation of a new innovative ureteral access sheath (Re-Trace™): a European study. World J Urol 32:143–147

    Article  PubMed  Google Scholar 

  12. Somani BK, Robertson A, Kata SG (2011) Decreasing the cost of flexible ureterorenoscopic procedures. Urology 78:528–530

    Article  PubMed  Google Scholar 

  13. Stern JM, Yiee J, Park S (2007) Safety and efficacy of ureteral access sheaths. J Endourol 21:119–123

    Article  PubMed  Google Scholar 

  14. Gurbuz C, Atış G, Arikan O et al (2014) The cost analysis of flexible ureteroscopic lithotripsy in 302 cases. Urolithiasis 42:155–158

    Article  PubMed  Google Scholar 

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Acknowledgments

Authors’ contribution

Alberto Breda MD: Protocol/project development, Data collection or management, Manuscript writing/editing. Esteban Emiliani MD: Data collection or management, Manuscript writing/editing. Felix Millán MD Ph.D…: Data analysis. Cesare Marco Scoffone MD: Protocol/project development, Data collection or management, Manuscript writing/editing. Thomas Knoll MD Ph.D. MSc: Protocol/project development, Data collection or management, Manuscript writing/editing. Palle J. S. Osther MD Ph.D.: Protocol/project development, Data collection or management, Manuscript writing/editing. Evangelos Liatsikos MD Ph.D.: Protocol/project development, Data collection or management, Manuscript writing/editing.

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Authors and Affiliations

  1. Department of Urology, Fundació Puigvert, Universitat Autonoma de Barcelona, Barcelona, Spain

    Alberto Breda, Esteban Emiliani & Felix Millán

  2. Department of Urology, Cottolengo Hospital, Turin, Italy

    Cesare Marco Scoffone

  3. Department of Urology, Klinikum Sindelfingen, University of Tübingen, Tübingen, Germany

    Thomas Knoll

  4. Department of Urology, Lillebaelt Hospital, University of Southern Denmark, Fredericia, Denmark

    Palle J. S. Osther

  5. Department of urology, University of Patras, Patron, Greece

    Evangelos Liatsikos

Authors
  1. Alberto Breda
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  2. Esteban Emiliani
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  3. Felix Millán
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  4. Cesare Marco Scoffone
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  5. Thomas Knoll
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  6. Palle J. S. Osther
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  7. Evangelos Liatsikos
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Corresponding author

Correspondence to Alberto Breda.

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Conflict of interest

The study was financially supported by COOK®. Alberto Breda is advisor for Karl Storz and Cook Medical, Esteban Emiliani has no competing financial interests, Felix Millán is advisor for Cook Medical, Cesare Marco Scoffone is advisor for Karl Storz, Boston Scientific, Porges Coloplst, Cook Medical and Lumenid, Thomas Knoll is advisor for Cook Medical, Palle J. S. Osther is advisor for Cook Medical, Karl Storz Endoskope, Olympus Boston Scientific, Porges Coloplast and Storz Medical, and Evangelos Liatsikos is advisor for Cook Medical.

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Breda, A., Emiliani, E., Millán, F. et al. The new concept of ureteral access sheath with guidewire disengagement: One wire does it all. World J Urol 34, 603–606 (2016). https://doi.org/10.1007/s00345-015-1638-9

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  • DOI: https://doi.org/10.1007/s00345-015-1638-9

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