Boston—A new single-use digital flexible ureteroscope (LithoVue) compares favorably in performance to reusable scopes, at least for routine urteroscopy, with a possible advantage of being more economical.
The experience of two institutions using the single-use ureteroscope was reported at the AUA annual meeting in Boston.
In a retrospective review of the first 75 cases with the 7.7F disposable flexible digital ureteroscope at the University of Southern California Institute of Urology and Norris Comprehensive Cancer Center, Los Angeles, study authors found its use to be satisfactory for the treatment of renal stones.
“We found that for our general stone cases, it works great,” said Eli Thompson, MD, urology resident at the University of Southern California. “It’s ergonomic and lightweight, and you can really torque on it without the fear of losing your scope by sending it off for a pricey repair if you break it.
“In the past year, this has become our ‘go to’ scope for our standard stone cases,” added Dr. Thompson, who worked on the study with Matthew D. Dunn, MD, and colleagues.
The reasons for ureteroscopy were stone disease in 60 patients, ureteral stricture disease in five patients, and upper tract transitional cell carcinoma in 10 patients. Ureteroscopy was initiated easily in all but three cases, one due to distal ureteral narrowing that required balloon dilation and two due to proximal ureter narrowing that required stenting. Two patients with ureteroenteric anastomotic disease required antegrade ureteroscopy.
Visualization problems included mild interference in the video system during laser lithotripsy of calcium oxalate monohydrate stones that did not prevent treatment. Use of the single-use ureteroscope is incompatible with electrocautery; during fulguration of upper tract transitional cell carcinoma, the use of a 3F electrode resulted in system reboot.
There was difficulty identifying the true lumen past the stricture with distant focusing during ureteroenteric anastomotic stricture, which led to inaccurate incision of the soft tissue resulting in extravasation.
“The new disposable ureteroscope works well for routine ureteroscopy with laser lithotripsy,” the investigators concluded, but should not be used with electrocautery and should be avoided for antegrade incision of ureteroenteric anastomotic stricture.