Category: Stones: Ureteroscopy

VS5-11 - Single use flexible ureteroscope visualization: comparison of VPU and laptop adaptor device

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective :

There are several concerns with the current state of reusable ureteroscopy. Several expensive pieces of capital such as video monitors and VPU’s are needed to supply an endoscopy suite for digital ureteroscopy.  This is a potential obstacle for centers in developing countries and community centers domestically.  Further, there is concern of cross-infection between cases in the event of improper sterilization of a reusable scope.  This has lead to a recent increase in demand for single-use ureteroscopes. The current study explores the Neoscope single-use fiexible digital ureteroscope, which has the potential for cost savings compared to reusable ureteroscopes. 


Methods :

This Neoscope (9-French diameter, 3.6-French working channel) is capable of bidirectional deflection of the tip to 270 degrees. A lightweight cable connects the scope to the VPU which is capable of recording video streams, still images, as well as white-balancing, and can connect directly into the standard OR monitor.  The Neoscope is also capable of connecting to a portable laptop adaptor module, which can produce and record high-resolution video to any Windows-based laptop or tablet computer via a standard USB 2.0 cable.  In this study we demonstrate both modalities in a patient treated for renal calculi at our institution. 


Results :

A patient with a 20x14x12 mm calcium oxalate stone in the right renal pelvis presented for flexible ureteroscopy.  The passage of the ureteroscope through the proximal ureter and into the renal pelvis was performed both via connection to the VPU and then immediately followed by connection to the laptop adaptor module for purposes of comparison between the modalities.  For the portion of the case in which the Neoscope was connected to the VPU, the urologist visualized the patient anatomy and stone on the standard OR monitor, which is represented in the right side panel.  For the portion of the case in which the Neoscope was connected to the laptop adaptor, the urologist used exclusively the laptop screen for visualization, which is represented in the left panel. After the stone was visualized, lithotripsy was performed using a 365 micron Holmium laser.  Visualization was comparable between the two modalities for all aspects of the procedure. 


Conclusions :

Financial limitations prevent many hospitals in developing countries and domestic community centers from being able to perform flexible ureteroscopy.  The Neoscope VPU and portable laptop adaptor have the potential to provide image quality comparable to that of reusable ureteroscopy, with the added potential for cost savings relative to conventional VPU’s and monitors. 

Scott G. Hubosky

Professor
Department of Urology, Thomas Jefferson University Hospital
Philadelphia, Pennsylvania

Brian P. Calio

Clinical Research Fellow
Department of Urology, Thomas Jefferson University Hospital
Philadelphia, Pennsylvania

Joon Yau Leong

Clinical Researcher
Thomas Jefferson University
Philadelphia, Pennsylvania

Demetrius H. Bagley

Professor
Department of Urology, Thomas Jefferson University Hospital
Philadelphia, Pennsylvania