Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study

Kazumi Taguchi, Jonathan D. Harper, Marshall L. Stoller, Brian Duty, Mathew D. Sorensen, Roger L. Sur, Manint Usawachintachit, David T. Tzou, David L. Wenzler, Dylan Isaacson, Angela Xu, Carissa Chu, Uwais B. Zaid, Eric R. Taylor, Krishna Ramaswamy, Thomas Chi

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. 424 URS cases using 74 flexible ureteroscopes were identified. Scope repair was required in 28 cases (6.6%) involving 26 scopes (35.1%). Upon univariate analysis, shorter patient height, absence of guidewire use, presence of a ureteral access sheath (UAS), longer procedure time, larger stone size, lithotrite type, surgeon training level, and self-reported concern were associated with scope repair. Upon multivariate analysis, UAS use (OR = 2.53, p = 0.005) and degree loss of scope upward flexion during a case (OR = 1.02, p = 0.03) increased the odds of a scope needing repair while the use of safety guidewire decreased the odds of a scope repair (OR = 0.50, p = 0.045). Lithotrite use and surgeon concern were associated with degree loss of scope upward flexion. The use of a UAS, absence of a safety guidewire, and the loss of upward ureteroscope flexion should be considered when evaluating means of optimizing reusable ureteroscope durability.

Original languageEnglish (US)
Pages (from-to)1-8
Number of pages8
JournalUrolithiasis
DOIs
StateAccepted/In press - Dec 9 2017

Fingerprint

Ureteroscopes
Cohort Studies
Prospective Studies
Ureteroscopy
Research
Safety
Multivariate Analysis
Maintenance
Costs and Cost Analysis
Surgeons

Keywords

  • Durability
  • Reusable flexible ureteroscope
  • Scope repair
  • Ureteral access sheath
  • Ureteroscopy

ASJC Scopus subject areas

  • Urology

Cite this

Identifying factors associated with need for flexible ureteroscope repair : a Western Endourology STone (WEST) research consortium prospective cohort study. / Taguchi, Kazumi; Harper, Jonathan D.; Stoller, Marshall L.; Duty, Brian; Sorensen, Mathew D.; Sur, Roger L.; Usawachintachit, Manint; Tzou, David T.; Wenzler, David L.; Isaacson, Dylan; Xu, Angela; Chu, Carissa; Zaid, Uwais B.; Taylor, Eric R.; Ramaswamy, Krishna; Chi, Thomas.

In: Urolithiasis, 09.12.2017, p. 1-8.

Research output: Contribution to journalArticle

Taguchi, K, Harper, JD, Stoller, ML, Duty, B, Sorensen, MD, Sur, RL, Usawachintachit, M, Tzou, DT, Wenzler, DL, Isaacson, D, Xu, A, Chu, C, Zaid, UB, Taylor, ER, Ramaswamy, K & Chi, T 2017, 'Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study', Urolithiasis, pp. 1-8. https://doi.org/10.1007/s00240-017-1013-y
Taguchi, Kazumi ; Harper, Jonathan D. ; Stoller, Marshall L. ; Duty, Brian ; Sorensen, Mathew D. ; Sur, Roger L. ; Usawachintachit, Manint ; Tzou, David T. ; Wenzler, David L. ; Isaacson, Dylan ; Xu, Angela ; Chu, Carissa ; Zaid, Uwais B. ; Taylor, Eric R. ; Ramaswamy, Krishna ; Chi, Thomas. / Identifying factors associated with need for flexible ureteroscope repair : a Western Endourology STone (WEST) research consortium prospective cohort study. In: Urolithiasis. 2017 ; pp. 1-8.
@article{11d33f649b8640bfa01ba8071b062bca,
title = "Identifying factors associated with need for flexible ureteroscope repair: a Western Endourology STone (WEST) research consortium prospective cohort study",
abstract = "Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. 424 URS cases using 74 flexible ureteroscopes were identified. Scope repair was required in 28 cases (6.6{\%}) involving 26 scopes (35.1{\%}). Upon univariate analysis, shorter patient height, absence of guidewire use, presence of a ureteral access sheath (UAS), longer procedure time, larger stone size, lithotrite type, surgeon training level, and self-reported concern were associated with scope repair. Upon multivariate analysis, UAS use (OR = 2.53, p = 0.005) and degree loss of scope upward flexion during a case (OR = 1.02, p = 0.03) increased the odds of a scope needing repair while the use of safety guidewire decreased the odds of a scope repair (OR = 0.50, p = 0.045). Lithotrite use and surgeon concern were associated with degree loss of scope upward flexion. The use of a UAS, absence of a safety guidewire, and the loss of upward ureteroscope flexion should be considered when evaluating means of optimizing reusable ureteroscope durability.",
keywords = "Durability, Reusable flexible ureteroscope, Scope repair, Ureteral access sheath, Ureteroscopy",
author = "Kazumi Taguchi and Harper, {Jonathan D.} and Stoller, {Marshall L.} and Brian Duty and Sorensen, {Mathew D.} and Sur, {Roger L.} and Manint Usawachintachit and Tzou, {David T.} and Wenzler, {David L.} and Dylan Isaacson and Angela Xu and Carissa Chu and Zaid, {Uwais B.} and Taylor, {Eric R.} and Krishna Ramaswamy and Thomas Chi",
year = "2017",
month = "12",
day = "9",
doi = "10.1007/s00240-017-1013-y",
language = "English (US)",
pages = "1--8",
journal = "Urolithiasis",
issn = "2194-7228",
publisher = "Springer Verlag",

}

TY - JOUR

T1 - Identifying factors associated with need for flexible ureteroscope repair

T2 - a Western Endourology STone (WEST) research consortium prospective cohort study

AU - Taguchi, Kazumi

AU - Harper, Jonathan D.

AU - Stoller, Marshall L.

AU - Duty, Brian

AU - Sorensen, Mathew D.

AU - Sur, Roger L.

AU - Usawachintachit, Manint

AU - Tzou, David T.

AU - Wenzler, David L.

AU - Isaacson, Dylan

AU - Xu, Angela

AU - Chu, Carissa

AU - Zaid, Uwais B.

AU - Taylor, Eric R.

AU - Ramaswamy, Krishna

AU - Chi, Thomas

PY - 2017/12/9

Y1 - 2017/12/9

N2 - Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. 424 URS cases using 74 flexible ureteroscopes were identified. Scope repair was required in 28 cases (6.6%) involving 26 scopes (35.1%). Upon univariate analysis, shorter patient height, absence of guidewire use, presence of a ureteral access sheath (UAS), longer procedure time, larger stone size, lithotrite type, surgeon training level, and self-reported concern were associated with scope repair. Upon multivariate analysis, UAS use (OR = 2.53, p = 0.005) and degree loss of scope upward flexion during a case (OR = 1.02, p = 0.03) increased the odds of a scope needing repair while the use of safety guidewire decreased the odds of a scope repair (OR = 0.50, p = 0.045). Lithotrite use and surgeon concern were associated with degree loss of scope upward flexion. The use of a UAS, absence of a safety guidewire, and the loss of upward ureteroscope flexion should be considered when evaluating means of optimizing reusable ureteroscope durability.

AB - Maintenance of flexible ureteroscopes can involve high costs and administrative burden. Instrument fragility necessitates eventual repair, rendering scopes inaccessible during refurbishment. We conducted a multi-institutional prospective cohort study to identify perioperative factors influencing flexible ureteroscope durability. Patients undergoing flexible ureteroscopy (URS) at six United States endourology centers were enrolled between August 2014 and June 2015. Surgeon self-reported concern and satisfaction with scope performance as well as upward and downward angles of deflection for each scope tip were measured before and after each procedure. The need for scope repair was determined by the operating surgeon at the time of the procedure and recorded. 424 URS cases using 74 flexible ureteroscopes were identified. Scope repair was required in 28 cases (6.6%) involving 26 scopes (35.1%). Upon univariate analysis, shorter patient height, absence of guidewire use, presence of a ureteral access sheath (UAS), longer procedure time, larger stone size, lithotrite type, surgeon training level, and self-reported concern were associated with scope repair. Upon multivariate analysis, UAS use (OR = 2.53, p = 0.005) and degree loss of scope upward flexion during a case (OR = 1.02, p = 0.03) increased the odds of a scope needing repair while the use of safety guidewire decreased the odds of a scope repair (OR = 0.50, p = 0.045). Lithotrite use and surgeon concern were associated with degree loss of scope upward flexion. The use of a UAS, absence of a safety guidewire, and the loss of upward ureteroscope flexion should be considered when evaluating means of optimizing reusable ureteroscope durability.

KW - Durability

KW - Reusable flexible ureteroscope

KW - Scope repair

KW - Ureteral access sheath

KW - Ureteroscopy

UR - http://www.scopus.com/inward/record.url?scp=85037621941&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85037621941&partnerID=8YFLogxK

U2 - 10.1007/s00240-017-1013-y

DO - 10.1007/s00240-017-1013-y

M3 - Article

C2 - 29224057

AN - SCOPUS:85037621941

SP - 1

EP - 8

JO - Urolithiasis

JF - Urolithiasis

SN - 2194-7228

ER -