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The design of small-diameter stone baskets can affect the stone extraction times of physicians at various skill levels.
Chicago-The design of small-diameter stone baskets can affect the stone extraction times of physicians at various skill levels, according to research presented at the 2010 World Congress of Endourology and SWL.
Researchers from the University of Minnesota, Minneapolis studied the performance of three different retrieval systems: the 1.3F OptiFlex from Boston Scientific (Natick, MA), the 1.5F NCircle from Cook Medical (Bloomington, IN), and the 1.5F Halo from Sacred Heart Medical (Minnetonka, MN).
The experts removed stones at an average of 2 (±1) minutes in the ureteral model using the Halo instrument. Novices using the same instrument completed the procedure in the ureteral model at an average of 8 (±4) minutes. The Halo also produced the fastest overall average extraction times at 8 (±6) minutes by all groups in both models.
Design variables affect operating times
Just as there were differences in extraction times according to experience, there were also differences according to design. In the ureteral model, the Optiflex had the slowest overall extraction rate. Both the Halo and NCircle were significantly faster than the Optiflex in the hands of experts. In the calyceal model, the Halo was significantly faster than the NCircle in expert hands.
"Some of the variables that might affect results are the configuration of the wires, stiffness of the wires, and the radial dilation force," said Dr. Monga, currently director of Cleveland Clinic's Stevan Streem Center for Endourology & Stone Disease. "The radial force would be specifically important for procedures in the ureter."
When asked which basket or baskets he and his team preferred, Dr. Monga said that the clinical situation usually determined the choice of basket.
He and his colleagues added this study and others presented at the congress to more than 8 years of work examining the design and performance of endourologic instruments and procedures.
Dr. Monga serves as a consultant to Boston Scientific and Cook Medical.