Category: Clinical Stones: Ureteroscopy

MP29-1 - Damage of flexibile ureteroscope – experience after 3000 cases

Sun, Sep 23
2:00 PM - 4:00 PM

Introduction & Objective :

Flexible ureteroscopy is the method of treatment that has recognized the most ascending evolution in minimally invasive treatment of kidney lithiasis. We retrospectively analyzed the ureterorenoscopic procedures performed in our center and we assessed the maneuvers which deteriorated the ureteroscopes.


Methods : Between 2002 – 2018, 3000 diagnosis and treatment retrograde flexible ureteroscopic procedures were performed in our center and were retrospectively analyzed. We used over the years ureteroscopes provided by three manufacturers: three Storz first generation conventional flexible ureteroscopes, three digital Storz Flex Xc, one Wolf Cobra flexible ureteroscope and two Olympus URF-V flexible ureteroscopes, and seven Olympus URF-V2.


Results :

In all the Storz first generation flexible ureteroscopes, used in 194 cases, major repairs were imposed by breakage of optical fibers and subsequent loss of visibility. In 588 cases we used digital Flex-Xc ureteroscopes: in one external sheath was worn by friction with the distal tip of the access sheath, in one the deflection capabilities were progressively lost, and in the third one optical system chip failure. The fiberoptic Wolf Cobra, used in 68 cases, was accidentally broken during sterilization maneuvers. In 473 cases we used digital Olympus URF-V in which we encountered completely perforation between work channel and exterior and complete loss of deflection, respectively. Last type of ureteroscope was used has 1773 procedures. Perforation of the working channel and flooding of the deflection mechanism was encountered in 3 cases, loss of deflection in one case and total perforation of the ureteroscope in 2 cases. The seventh URF-V2 flexible ureteroscope is still operational.


Conclusions :

The emergence of modern new flexible ureteroscopes has increase the number of procedures and also increased their life time. Continuous improvements are always brought to the ureteroscopes but to date there is no perfect device that can address all the discussed weak points.

Bogdan Geavlete

Associate Professor of Urology
"Saint John" Emergency Clinical Hospital, Department of Urology, Bucharest, Romania
Bucharest, Bucuresti, Romania

Dr. Bogdan Geavlete, MD, PhD, is Associate Professor at the "Saint John" Emergency Clinical Hospital, Department of Urology in Bucharest, Romania. As a research scholar, his training included fellowships in endourology in general at Asklepios Klinik Barmbek in Hamburg, Germany, as well as in flexible ureteroscopy in particular, at Tenon Hospital in Paris, France. Dr. Geavlete also completed a European Urological Scholarship Programme (EUSP) clinical fellowship at Radboud University, in Nijmegen, The Netherlands.
During the past 10 years, he was involved as faculty (speaker and moderator) in the most prestigious urological international events such as the EAU, AUA, WCE, SIU, CEM, EULIS and Challenges in Endourology annual meetings, while also co-authoring over 300 posters and videos.
His main areas of expertise and research focuses have been centered on non-muscle invasive bladder cancer (PhD in photodynamic diagnostic, international premiere and randomized clinical research in plasma-button large tumors’ vaporization), benign prostatic obstruction (prospective, randomized-controlled studies in BPH bipolar plasma enucleation published in famous ISI journals) and urolithiasis (international speaker, moderator and trainer in flexible ureteroscopy).
Dr. Geavlete gained 10 international awards for best posters, videos or oral presentations in the most important congresses of the urological international scientific agenda such as the EAU, CEM, EMUC, Experts in stone disease, Engineering and Urology Society and Challenges in Endourology & Functional Urology meetings. Also, he is an investigator in multicenter international clinical trials as well as in national research grants, while also completing a post-PhD research fellowship in narrow band imaging. He is a member in the organizing committees of national congresses and earned 5 national awards.
Over the past decade, Dr. Geavlete has been selected as a reviewer for 31 international journals, published 3 books in international publishing houses and 26 articles in international ISI journals and co-authored 68 PubMed indexed articles.

Razvan Multescu

Bucharest, Bucuresti, Romania

Catalin Bulai

Bucharest, Bucuresti, Romania

Petrisor Geavlete

Professor
Saint John Emergency clinical Hospital
Bucharest, Bucuresti, Romania

Professor of Urology, Chairman of the "Saint John" Emergency Clinical Hospital, Department of Urology, Vice-president of the Romanian Association of Urology