Department of Urologic Surgery, University of Minnesota, Minneapolis, Minnesota, USA.
J Endourol. 2011 Sep;25(9):1411-4. doi: 10.1089/end.2010.0642. Epub 2011 Jul 28.
Despite the evolution and progressive improvements of ureteroscopes, problems related to visibility and maneuverability can still hinder the goals of surgical intervention. We evaluate the attributes of a dual-channel flexible ureteroscope compared with a single-channel device and discuss the implications for expanded techniques afforded by this new technology.
In vitro measurements of active deflection, irrigant flow through the working channel, luminescence, and optical resolution were performed between the single-channel Wolf Viper and the dual-channel Wolf Cobra ureteroscopes. Characteristics were obtained with the working channels both empty and with combinations of a 200 μ holmium aser fiber, 3.0F biopsy forceps, and 1.5F, 2.4F, and 2.8F nitinol basket. Luminescence from each scope was measured using a commercial luminometer. Three blinded physicians rated the optical resolution captured electronically using a standard test image.
The single-channel scope has improved upward deflection both empty and with all but the largest single tools, with an improved range of 4 to 15 degrees. The dual-channel scope has superior downward deflection across all comparisons (average increase of 24.5 degrees) and superior upward deflection with large or multiple instruments in the working channel. Baseline flows through each individual-channel of the dual-channel scope were slower than the larger single-channel ureteroscope. Because flow can be provided through a dedicated port in the dual-channel configuration, however, overall flow, depending on instrumentation, can be up to 37 times faster than the single-channel (range 1.5-37×). Optical resolution and luminescence are comparable between the two scopes.
The dual-channel flexible ureteroscope provides similar deflection characteristics to the current single-channel scope. Deflection and flow characteristics are superior, however, when larger or multiple simultaneous instruments are used in the working channel. These benefits may facilitate the development and implementation of novel endoscopic procedures.
尽管输尿管镜不断发展并逐步改进，但与可视性和可操作性相关的问题仍可能阻碍手术干预的目标。我们评估了双通道软镜与单通道设备的特性，并讨论了这项新技术带来的扩展技术的意义。
对单通道 Wolf Viper 与双通道 Wolf Cobra 输尿管镜之间的主动弯曲度、工作通道中的冲洗液流量、发光和光学分辨率进行了体外测量。在工作通道为空以及组合使用 200 μ 钬激光光纤、3.0F 活检钳以及 1.5F、2.4F 和 2.8F 镍钛诺篮时，获得了这些特性。使用商业光度计测量每根镜的发光度。三名盲法医生对使用标准测试图像电子捕获的光学分辨率进行了评分。
单通道镜在所有情况下（除了最大的单一工具外）均改善了向上弯曲度，其范围提高了 4 至 15 度。双通道镜在所有比较中均具有更好的向下弯曲度（平均增加 24.5 度），并且在工作通道中使用大工具或多个工具时具有更好的向上弯曲度。双通道镜每个单独通道的基线流量均比较大的单通道输尿管镜慢。但是，由于双通道配置中可以提供专用端口的流量，因此根据仪器的不同，总体流量最快可以提高 37 倍（范围为 1.5 至 37 倍）。两种镜的光学分辨率和发光度相当。
双通道软镜提供了与当前单通道镜相似的弯曲特性。然而，当在工作通道中使用更大或多个同时的仪器时，其弯曲度和流量特性则更优。这些优势可能有助于新型内镜手术的开发和实施。
