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 language | English (US) |
|---|---|
| Pages (from-to) | 1-8 |
| Number of pages | 8 |
| Journal | Urolithiasis |
| DOIs | |
| State | Accepted/In press - Dec 9 2017 |
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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 journal › Article
}
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 -