004IC - Maximizing New Technological Advances in Ureteroscopy and Associated Instrumentation

Friday, April 28, 2023

7:30 AM – 9:30 AM CST

Location: S103C

Instructional Course Director(s)

Scott Hubosky, MD

Sidney Kimmel Medical School at Thomas Jefferson University Hospital
Olivier Traxer, MD

University La Sorbonne

Instructional Course Faculty(s)

Michael Grasso, III, MD

New York Medical College

Ureteroscopy is a widely utilized treatment option for nephroureterolithiasis, upper tract neoplasms and strictures. Over the last three decades, there have been progressive improvements in both ureteroscope design as well as ancillary equipment to maximize surgical effectiveness while minimizing treatment morbidity. More recently, we have seen multiple new advances including single-use flexible ureteroscopes, enhanced laser technology capable of producing extremely small resultant stone fragments, and irrigation systems designed to remove small stone fragments and improve visibility. The practical challenge for the contemporary endourologist is understanding the role of all this new technology to achieve the best patient outcomes while being a good steward of operating room resources.

This instructional course will provide the learners with exposure to newly available ureteroscopic instruments and ancillary devices in the context of treatment of upper tract stone disease, upper tract neoplasms and upper tract obstructions. Any and all published data on outcomes using these new modalities will be critically reviewed as well as general cost considerations. Special attention will be given to safety aspects of the new technology as well as avoidance of potential complications.

Learning Objective 8:

Learning Objectives:

Describe fundamental ureteroscope design and function for both flexible and semirigid instruments, and discuss the advantages and disadvantages of fiberoptic and digital models in both reusable and single-use versions.
Classify which ureteroscopes are ideal for a given clinical situation.
Identify available laser technologies including high-powered holmium, thulium fiber lasers and others, and know the role for each in terms of stone treatment, upper tract tumor ablation and stricture incision. Optimal laser settings will also be reviewed for given clinical situations.
Describe which patients with upper tract urothelial carcinoma are appropriate for conservative ureteroscopic treatment, and explain when to apply adjuvant therapies such as intraluminal medications and systemic treatments.
Describe the latest ureteroscopic ancillary equipment and know when it is cost-effective to use.
Identify which patients are high risk for complications from ureteroscopy and work toward minimizing these risks.