Presentation Authors: Brenton Winship*, Daniel Wollin, Evan Carlos, Durham, NC, Jingqiu Li, Singapore, Singapore, Russell Terry, Kohldon Boydston, Glenn Preminger, Michael Lipkin, Durham, NC
Introduction: Single-use flexible ureteroscopes are increasingly popular due to recent attention to repair costs and adequacy of sterilization of reusable scopes. The Boston Scientific LithoVue is the most widely used single-use scope in the US. However, as new single-use scopes enter the market, the consistency of performance of these devices has been questioned. Our objective was to compare two digital single-use ureteroscopes: the Pusen PU3022a (Zhuhai Pusen) and the LithoVue (Boston Scientific) with emphasis on physical and optical performance consistency.
Methods: 10 LithoVue and 10 Pusen scopes were evaluated in never-used condition. The following parameters were recorded: maximal tip deflection with an empty working channel, 200Âµm laser fiber, and 1.9fr basket; image resolution at 10, 20, and 50mm; irrigation flow rate at 50cm/H20; and blinded review of videos during laser lithotripsy for image interference. All scopes were then fully deflected for 200 cycles. Maximum deflection was re-measured. Mean values for each parameter were compared. To examine within-manufacturer consistency, the variance was calculated and an F-test performed to evaluate for equivalence.
Results: Both scopes provided max deflection over 270Â°. The Pusen scope demonstrated significantly greater deflection than LithoVue in unused condition with an empty working channel. (291.1Â° vs 280.3Â°, p = 0.0004). The Pusen lost more deflection with a laser fiber in the working channel (15.5Â° vs. 8.3Â°, p=0.0006. The scopes had similar deflection loss with a basket in the channel. Lithovue had higher resolution at 10mm (3.7 vs 4.6lp/mm, p < 0.0001), but the scopes were similar at 20 and 50mm. Irrigation flow was higher with the Pusen, however its working channel is 7cm shorter than Lithovue. Minimal laser- image interference was noted with either scope. After 200 deflections, LithoVue demonstrated less mean deflection loss (21.8Â° vs 37.7Â°, p=0.02), although one scope was excluded from analysis due to mechanical failure. Variability was minimal and not significant between manufacturers at all measured parameters.
Conclusions: LithoVue and the newer Pusen PU3022a have similar &[Prime]out- of-the-box&[Prime] performance characteristics and appear durable in benchtop testing. These two single-use flexible ureteroscopes performed consistently regardless of manufacturer.
Source of Funding: Boston Scientific