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Safety and Care of Ureteroscopic Instruments

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Ureteroscopy

Abstract

The complex and fragile nature of flexible ureteroscopes leads to issues regarding their reliability and maintenance costs. The durability of ureteroscopes is related not only to their design but also to the technique used by and experience of the operator. The current chapter provides information on how to use, clean, sterilize, and store flexible ureteroscopes in order to avoid costly repairs. The impact of single-use ureteroscopes is also discussed.

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Abbreviations

fURS:

Flexible ureteroscopy

References

  1. Wickham JE. Treatment of urinary tract stones. BMJ (Clin Res Ed). 1993;307(6916):1414–7.

    CAS  Google Scholar 

  2. Beiko DT, Denstedt JD. Advances in ureterorenoscopy. Urol Clin North Am. 2007;34(3):397–408.

    PubMed  Google Scholar 

  3. Papatsoris AG, Kachrilas S, Howairis ME, Masood J, Buchholz N. Novel technologies in flexible ureterorenoscopy. Arab J Urol. 2011;9(1):41–6.

    PubMed  PubMed Central  Google Scholar 

  4. Carey RI, Gomez CS, Maurici G, Lynne CM, Leveillee RJ, Bird VG. Frequency of ureteroscope damage seen at a tertiary care center. J Urol. 2006;176(2):607–10; discussion 10.

    PubMed  Google Scholar 

  5. Traxer O, Dubosq F, Jamali K, Gattegno B, Thibault P. New-generation flexible ureterorenoscopes are more durable than previous ones. Urology. 2006;68(2):276–9. discussion 80

    PubMed  Google Scholar 

  6. Al-Qahtani SM, Geavlete B, Geavlette BP, de Medina SG-D, Traxer OP. The new Olympus digital flexible ureteroscope (URF-V): initial experience. Urology annals. 2011;3(3):133–7.

    PubMed  PubMed Central  Google Scholar 

  7. Binbay M, Yuruk E, Akman T, Ozgor F, Seyrek M, Ozkuvanci U, et al. Is there a difference in outcomes between digital and fiberoptic flexible ureterorenoscopy procedures? J Endourol. 2010;24(12):1929–34.

    PubMed  Google Scholar 

  8. Sung JC, Springhart WP, Marguet CG, L’Esperance JO, Tan YH, Albala DM, et al. Location and etiology of flexible and semirigid ureteroscope damage. Urology. 2005;66(5):958–63.

    PubMed  Google Scholar 

  9. Afane JS, Olweny EO, Bercowsky E, Sundaram CP, Dunn MD, Shalhav AL, et al. Flexible ureteroscopes: a single center evaluation of the durability and function of the new endoscopes smaller than 9Fr. J Urol. 2000;164(4):1164–8.

    CAS  PubMed  Google Scholar 

  10. User HM, Hua V, Blunt LW, Wambi C, Gonzalez CM, Nadler RB. Performance and durability of leading flexible ureteroscopes. J Endourol. 2004;18(8):735–8.

    PubMed  Google Scholar 

  11. McDougall EM, Afane JS, Dunn MD, Shalhav AL, Clayman RV. Laparoscopic management of retrovesical cystic disease: Washington University experience and review of the literature. J Endourol. 2001;15(8):815–9.

    CAS  PubMed  Google Scholar 

  12. Pietrow PK, Auge BK, Delvecchio FC, Silverstein AD, Weizer AZ, Albala DM, et al. Techniques to maximize flexible ureteroscope longevity. Urology. 2002;60(5):784–8.

    PubMed  Google Scholar 

  13. Wendth-Nordahl G, Mut T, Krombach P, et al. Do new generation ureterorenoscopes offer a higher treatment success than their predecessors? Urol Res. 2011;39. SRC – BaiduScholar:185–8.

    Google Scholar 

  14. Zilberman DE, Tsivian M, Yong D, Albala DM. Surgical steps that elongate operative time in robot-assisted radical prostatectomy among the obese population. J Endourol. 2011;25(5):793–6.

    PubMed  Google Scholar 

  15. Karaolides T, Bach C, Kachrilas S, Goyal A, Masood J, Buchholz N. Improving the durability of digital flexible ureteroscopes. Urology. 2013;81(4):717–22.

    PubMed  Google Scholar 

  16. Ghani KR, Bultitude M, Hegarty N, Thomas K, Glass J. Flexible ureterorenoscopy (URS) for lower pole calculi. BJU Int. 2012;110(2):294–8.

    PubMed  Google Scholar 

  17. Ng YH, Somani BK, Dennison A, Kata SG, Nabi G, Brown S. Irrigant flow and intrarenal pressure during flexible ureteroscopy: the effect of different access sheaths, working channel instruments, and hydrostatic pressure. J Endourol. 2010;24(12):1915–20.

    PubMed  Google Scholar 

  18. Kourambas J, Byrne RR, Preminger GM. Does a ureteral access sheath facilitate ureteroscopy? J Urol. 2001;165(3):789–93.

    CAS  PubMed  Google Scholar 

  19. Breda A, Territo A, López-Martínez JM. Benefits and risks of ureteral access sheaths for retrograde renal access. Curr Opin Urol. 2016;26(1):70–5.

    PubMed  Google Scholar 

  20. Traxer O, Thomas A. Prospective evaluation and classification of ureteral wall injuries resulting from insertion of a ureteral access sheath during retrograde intrarenal surgery. J Urol. 2013;189(2):580–4.

    PubMed  Google Scholar 

  21. Somani BK, Aboumarzouk O, Srivastava A, Traxer O. Flexible ureterorenoscopy: tips and tricks. Urology Ann. 2013;5(1):1–6.

    Google Scholar 

  22. Sprunger JK, Herrell SD. Techniques of ureteroscopy. Urol Clin North Am. 2004;31(1):61–9.

    PubMed  Google Scholar 

  23. Monga M, Dretler SP, Landman J, Slaton JW, Conradie MC, Clayman RV. Maximizing ureteroscope deflection: “play it straight”. Urology. 2002;60(5):902–5.

    PubMed  Google Scholar 

  24. Sooriakumaran P, Kaba R, Andrews HO, Buchholz NPN. Evaluation of the mechanisms of damage to flexible ureteroscopes and suggestions for ureteroscope preservation. Asian J Androl. 2005;7(4):433–8.

    CAS  PubMed  Google Scholar 

  25. Sooriakumaran P, Buchholz NPN. Who broke the ureteroscope? BJU Int. 2004;94(1):4–5.

    PubMed  Google Scholar 

  26. Aiello AE, Larson EL, Sedlak R. Hidden heroes of the health revolution. Sanitation and personal hygiene. Am J Infect Control. 2008;36(10 Suppl):S128–51.

    PubMed  Google Scholar 

  27. Semins MJ, George S, Allaf ME, Matlaga BR. Ureteroscope cleaning and sterilization by the urology operating room team: the effect on repair costs. J Endourol. 2009;23(6):903–5.

    PubMed  Google Scholar 

  28. Recommended practices for cleaning and caring for surgical instruments and powered equipment. AORN J. 2002;75:627–41.

    Google Scholar 

  29. Vrancich A. Instrumental care. Creating longevity through proper maintenance. Mater Manag Health Care. 2003;12(3):22–5.

    PubMed  Google Scholar 

  30. Clemens JQ. Afferent neurourology: an epidemiological perspective. J Urol. 2010;184(2):432–9.

    PubMed  Google Scholar 

  31. Association for the Advancement of Medical Instrumentation. ST91 Flexible and semirigid endoscope processing in health care facilities. 2015.

    Google Scholar 

  32. Rutala WA, Weber DJ. Reprocessing semicritical items: current issues and new technologies. Am J Infect Control. 2016;44(5 Suppl):e53–62.

    PubMed  Google Scholar 

  33. Ordon M, Urbach D, Mamdani M, Saskin R, Honey RJDA, Pace KT. A population based study of the changing demographics of patients undergoing definitive treatment for kidney stone disease. J Urol. 2015;193(3):869–74.

    PubMed  Google Scholar 

  34. Knudsen B, Miyaoka R, Shah K, Holden T, Turk TMT, Pedro RN, et al. Durability of the next-generation flexible fiberoptic ureteroscopes: a randomized prospective multi-institutional clinical trial. Urology. 2010;75(3):534–8.

    PubMed  Google Scholar 

  35. Landman J, Lee DI, Lee C, Monga M. Evaluation of overall costs of currently available small flexible ureteroscopes. Urology. 2003;62(2):218–22.

    PubMed  Google Scholar 

  36. Shah K, Monga M, Knudsen B. Prospective randomized trial comparing 2 flexible digital ureteroscopes: ACMI/Olympus Invisio DUR-D and Olympus URF-V. Urology. 2015;85(6):1267–71.

    PubMed  Google Scholar 

  37. Kramolowsky E, McDowell Z, Moore B, Booth B, Wood N. Cost analysis of flexible ureteroscope repairs: evaluation of 655 procedures in a community-based practice. J Endourol. 2016;30(3):254–6.

    PubMed  Google Scholar 

  38. Taguchi K, Harper JD, Stoller ML, Duty BD, Sorensen MD, Sur RL, et al. Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study. Urolithiasis. 2018;46(6):559–66. https://doi.org/10.1007/s00240-017-1013-y.

  39. Proietti S, Dragos L, Molina W, Doizi S, Giusti G, Traxer O. Comparison of new single-use digital flexible ureteroscope versus nondisposable fiber optic and digital ureteroscope in a cadaveric model. J Endourol. 2016;30(6):655–9.

    PubMed  PubMed Central  Google Scholar 

  40. Usawachintachit M, Isaacson DS, Taguchi K, Tzou DT, Hsi RS, Sherer BA, et al. A prospective case-control study comparing LithoVue, a single-use, flexible disposable ureteroscope, with flexible, reusable fiber-optic ureteroscopes. J Endourol. 2017;31(5):468–75.

    PubMed  PubMed Central  Google Scholar 

  41. Davis NF, Quinlan MR, Browne C, Bhatt NR, Manecksha RP, D’Arcy FT, et al. Single-use flexible ureteropyeloscopy: a systematic review. World J Urol. 2018;36(4):529–36.

    CAS  PubMed  Google Scholar 

  42. Taguchi K, Usawachintachit M, Tzou DT, Sherer BA, Metzler I, Isaacson D, et al. Micro-costing analysis demonstrates comparable costs for LithoVue compared to reusable flexible fiberoptic ureteroscopes. J Endourol. 2018;32(4):267–73.

    PubMed  Google Scholar 

  43. Martin CJ, McAdams SB, Abdul-Muhsin H, Lim VM, Nunez-Nateras R, Tyson MD, et al. The economic implications of a reusable flexible digital ureteroscope: a cost-benefit analysis. J Urol. 2017;197(3 Pt 1):730–5.

    PubMed  Google Scholar 

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Kallidonis, P., Alfozan, M., Liatsikos, E. (2020). Safety and Care of Ureteroscopic Instruments. In: F. Schwartz, B., D. Denstedt, J. (eds) Ureteroscopy. Springer, Cham. https://doi.org/10.1007/978-3-030-26649-3_5

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  • DOI: https://doi.org/10.1007/978-3-030-26649-3_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-26648-6

  • Online ISBN: 978-3-030-26649-3

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