Johnston William K, Low Roger K, Das Sakti
Minimally Invasive Urology, University of Michigan, 1500 E. Medical Center Drive, Taubman Center 2916, Ann Arbor, MI 48109-0330, USA.
Urol Clin North Am. 2004 Feb;31(1):5-13. doi: 10.1016/S0094-0143(03)00100-9.
Technology and refinements in urology have prospered with the bonding of engineers and surgeons. The introduction of fiberoptics and the development of the ureteroscope opened the doors to the field of ureteroscopy. Advances in rigid and flexible ureteroscopy with irrigating and working channels have expanded the capability of the urologist to diagnose and treat most abnormalities of the upper tracts in adult and pediatric populations. Instrument development has easily paralleled the growth and development of the ureteroscope and has improved success, patient safety, and comfort with the incorporation of access sheaths, nitinol materials, and Ho:YAG laser technology. Owing to their minimal morbidity and high success rate, ureteroscopic evaluation and therapeutic interventions in the upper tract represent the gold standard of management. Albert Einstein said, "There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle." Contemporary ureteroscopy is a historical miracle that has opened a vista of endless limits in upper tract endoscopy (Fig. 4, Box 1).
随着工程师与外科医生的合作，泌尿外科技术及改进取得了蓬勃发展。光纤技术的引入和输尿管镜的发展为输尿管镜检查领域打开了大门。带有冲洗和工作通道的硬性及软性输尿管镜的进步，扩大了泌尿外科医生诊断和治疗成人及儿童大多数上尿路异常的能力。器械的发展很容易与输尿管镜的发展并驾齐驱，并且通过采用接入鞘、镍钛诺材料和钬激光技术，提高了成功率、患者安全性及舒适度。由于其发病率极低且成功率高，上尿路的输尿管镜评估和治疗干预代表了管理的金标准。阿尔伯特·爱因斯坦说过：“人只有两种活法。一种是把一切都视作平常，另一种是把一切都视作奇迹。”当代输尿管镜检查是一个历史性的奇迹，它开启了上尿路内镜检查无限可能的前景（图4，方框1）。
