Introduction: The introduction of the first single use ureteroscope over 5 years ago established a new paradigm in the surgical management of kidney stone disease and since then several new single use ureteroscopes have been developed. Furthermore, improvements in chip technology, resolution and maneuverability have been employed in this newer generation of single use ureteroscopes. This study sought to objectively test if a concept single use ureteroscope (Boston Scientific, USA, concept device, not available for sale) with pressure monitoring technology is able to achieve comparable optical performance and maneuverability as reference single use and reusable ureteroscopes.
Methods: We bench tested 3 single-use ureteroscopes, 1 reusable ureteroscope and the new concept Boston Scientific single-use ureteroscope with pressure monitoring technology. All scopes were brand new. Optical characteristics as well as manoeuverability were compared. Resolution was measured using a 1951 USAF 3x3 inch, positive Resolution Target at distances of 10mm, 20mm and 30mm using 5 different solutions. Field of view was measured. Manoeuverability and visualization was measured in cadaveric kidneys and 2 anesthetized farm pigs. Finally, pressure studies using a pressure sensing calibrator (ElveFlow OB1 Pressure Controller) was used to determine accuracy of the BSC concept device.
Results: The 365 micron laser fiber significantly decreased deflection for all scopes (Fig 1) and resolution significantly decreased for most scopes with increasing distance (Fig 2). Field of view of the BSC concept scope was found to be wider than all other scopes (Fig 3). Manoeuverability of scopes was found to be comparable. Notably, pressure readings from the concept scope and the pressure sensing calibrator strongly corelated with each other (r=0.9983) (Fig 4).
Conclusions: In this non-clinical study, concept ureteroscope with pressure monitoring technology was found to achieve comparable optical performance and maneuverability as the reference single use and reusable ureteroscopes. In regard to the pressure measurement capability, the readings from the concept single use flexible ureteroscope were comparable to the pressure sensing calibrator.
Source of Funding: This work was supported by Boston Scientific Inc
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