Chiu Kun-Yuan, Cai Yi, Marcovich Robert, El-Hakim Assaad, Smith Arthur D, Lee Benjamin R
Department of Urology, Long Island Jewish Medical Center, New Hyde Park, New York 11040, USA.
Urology. 2003 Nov;62(5):800-4. doi: 10.1016/s0090-4295(03)00672-1.
New designs have improved the ability of flexible ureteroscopes to assess the upper urinary tract. However, limitations of tip deflection may interfere with diagnosis and treatment of lower pole renal pathologic features and smaller working channels may impair irrigant flow. Our purpose was to compare the new flexible ureteroscopes with prior models to determine whether engineering advances have overcome these problems.
Two newly released flexible ureteroscopes, the ACMI DUR-8 Elite and the Storz 11278AU, were compared with four other ureteroscopes, the ACMI DUR-8, Storz 11274AAU, Olympus URF-P3, and Wolf 9F. Active tip deflection, irrigation flow rates, and intraluminal pressures with and without various endoscopic tools were assessed. The specifications, purchase prices, and repair costs were obtained from the individual manufacturers. Also, the field of view and screen image size of each scope were compared.
The ACMI DUR-8 Elite and Storz 11278AU had improved tip deflection of 79 degrees and 144 degrees, respectively, from previous ureteroscopes. Although the tip deflections of all ureteroscopes were compromised by the insertion of endoscopic tools, new ureteroscopes were less affected. With a 3F basket within the working channel, the ACMI DUR-8 Elite and the Storz 11278AU had a loss of downward deflection of only 0.7% and 2.8% compared with a loss of 9.6% and 5.0% for their older models, respectively. However, the flow rate of these new instruments was decreased.
The new flexible ureteroscopes have significantly better active tip deflection than previous models, both with and without endoscopic instrumentation inserted. However, improved flexibility comes at the expense of a decreased flow rate.
新设计提高了软性输尿管镜评估上尿路的能力。然而，尖端偏转的局限性可能会干扰下极肾脏病理特征的诊断和治疗，较小的工作通道可能会损害灌流。我们的目的是比较新型软性输尿管镜与先前型号，以确定技术进步是否克服了这些问题。
将两款新发布的软性输尿管镜，即ACMI DUR-8 Elite和STORZ 11278AU，与其他四款输尿管镜，即ACMI DUR-8、STORZ 11274AAU、奥林巴斯URF-P3和狼牌9F进行比较。评估了有无各种内镜工具时的主动尖端偏转、灌流速率和腔内压力。从各制造商处获取了规格、采购价格和维修成本。此外，还比较了每个镜的视野和屏幕图像大小。
与先前的输尿管镜相比，ACMI DUR-8 Elite和STORZ 11278AU的尖端偏转分别提高到79度和144度。尽管所有输尿管镜的尖端偏转都会因插入内镜工具而受到影响，但新型输尿管镜受影响较小。工作通道内有一个3F篮时，ACMI DUR-8 Elite和STORZ 11278AU向下偏转的损失仅为0.7%和2.8%，而其旧型号分别为9.6%和5.0%。然而，这些新器械的流速降低了。
新型软性输尿管镜在插入和未插入内镜器械时，其主动尖端偏转均明显优于先前型号。然而，柔韧性的提高是以流速降低为代价的。
