New Technology: Miscellaneous

Moderated Poster Session

MP22-6 - An Algorithmic Approach to Implementation of a Single-Use Digital Flexible Ureteroscope

Saturday, September 22
2:00 PM - 4:00 PM
Location: Room 252B

Introduction & Objective : Advances in flexible ureteroscope design have led to the transition from fiberoptic to digital ureteroscopy at many institutions. While digital ureteroscopes offer enhanced optics, they are also associated with increased repair costs. The selective use of a single-use digital flexible ureteroscope for complex cases may potentially preserve the life of reusable digital ureteroscopes, and thus reduce the amount of costly repairs. We present our algorithmic approach to implementation of a single-use digital flexible ureteroscope (LithoVue™ Single-use Digital Flexible Ureteroscope, Boston Scientific Corporation, Marlborough, MA) and evaluated the impact on scope repairs.


Methods :

An IRB approved retrospective review was performed of all ureteroscopy procedures at our institution between January 1, 2016 to December 31, 2017. The algorithm for using a single-use digital flexible ureteroscope was introduced in 2017, with inclusion indications: (1) large stone burden (> 1.5 cm), (2) multiple lower pole stones (> 3), (3) extensive ureteral/renal urothelial carcinoma with expected operative duration (> 1 hour), (4) bilateral ureteroscopy, (5) stones within complex/tortuous renal anatomy, and (6) placement of ureteroscope through a trocar during robotic or laparoscopic procedures. Perioperative data were analyzed, including number of procedures, repairs, and costs.


Results : All flexible ureteroscopy procedures were performed with a digital ureteroscope. The total number of ureteroscopy procedures was 418 (272 flexible, 146 semirigid) in 2016 and 398 (318 flexible, 80 semirigid) in 2017. The total number of ureteroscope repairs was 47 (2016) and 35 (2017). The cost savings from 2016 and 2017 was 21%. A total of 63 single-use ureteroscopy procedures were performed for the indications: (1) 35, (2) 9, (3) 14, (4) 5, (5) 6, and (6) 6. Of these, 14 procedures involved 2 (n=12) or 3 (n=1) indications. The single-use ureteroscope was used in 26 additional procedures when a reusable digital ureteroscope was not available to prevent surgery delay or cancellation which translated to a net profit.


Conclusions : Implementation of an algorithm for the LithoVue™ Single-use Digital Flexible Ureteroscope resulted in a decrease in reusable digital ureteroscope repair costs. The absolute indications for use of the single-use ureteroscope were created based on our prior experience with ureteroscope damage and a review of the literature. A single-use ureteroscope may be a reasonable alternative to subjecting the more expensive reusable ureteroscope to extensive stress and damage, while potentially resulting in cost savings at high volume institutions.

Johnson Tsui

Fellow, Endourology, Laparoscopy, Robotic Surgery
Hackensack University Medical Center

Presentation(s):

    Send Email for Johnson Tsui

    John Stites

    Fellow, Endourology, Laparoscopy, Robotic Surgery
    Hackensack University Medical Center

    Presentation(s):

      Send Email for John Stites

      John Stites

      Fellow, Endourology, Laparoscopy, Robotic Surgery
      Hackensack University Medical Center

      Presentation(s):

        Send Email for John Stites

        Gregory Lovallo

        Attending Urologist
        Hackensack University Medical Center

        Presentation(s):

          Send Email for Gregory Lovallo

          Mutahar Ahmed

          Attending Urologist
          Hackensack University Medical Center

          Mutahar Ahmed MD FACS
          Director of the Center for Bladder Cancer and Reconstructive Urologic Surgery at Hackensack University Medical Center, in Hackensack, NJ
          Clinical Assitant Professor Hackensack Meridian Seton Hall School of Medicine
          Clinical Assistant Professor Rutgers University School of Medicine

          Presentation(s):

            Send Email for Mutahar Ahmed

            Michael Degen

            Attending Urologist
            Hackensack University Medical Center

            Presentation(s):

              Send Email for Michael Degen

              Ravi Munver

              Professor & Vice Chair
              Hackensack University Medical Center

              Dr. Munver received his undergraduate education at Cornell University. He received his medical education at Cornell University Medical College and completed residency training in urologic surgery at Duke University Medical Center. He received fellowship training in robotic, laparoscopic, and endoscopic surgery at New York-Presbyterian Hospital/Weill Cornell Medical Center.

              Dr. Munver is Vice Chair and Chief of Minimally Invasive and Robotic Urologic Surgery in the Department of Urology at Hackensack University Medical Center. He is a Professor of Urology at Hackensack Meridian School of Medicine at Seton Hall University and at Rutgers New Jersey Medical School. He is the founding Director of the Hackensack University Medical Center Endourology, Laparoscopy, and Robotic Surgery Fellowship Program.

              Dr. Munver is a passionate academician and educator, and has lectured in 21 countries spanning 5 continents. He has authored more than 400 scientific manuscripts, articles, book chapters, and abstracts.

              Presentation(s):

                Send Email for Ravi Munver


                Assets

                MP22-6 - An Algorithmic Approach to Implementation of a Single-Use Digital Flexible Ureteroscope



                Attendees who have favorited this

                Please enter your access key

                The asset you are trying to access is locked. Please enter your access key to unlock.

                Send Email for MP22-6 - An Algorithmic Approach to Implementation of a Single-Use Digital Flexible Ureteroscope