Department of Urology, Saint John Emergency Clinical Hospital, Bucharest, Romania.
Urology. 2013 Dec;82(6):1236-9. doi: 10.1016/j.urology.2013.07.022. Epub 2013 Aug 28.
To comparatively study 3 of the latest models of flexible ureteroscopes using both subjective and objective parameters.
Three models of flexible ureteroscopes (Karl Storz Flex-Xc, Olympus URF-Vo, and Wolf Cobra) were evaluated during 90 procedures. For each model, 20 procedures were therapeutic for pyelocaliceal lithiasis and 10 were diagnostic. The maneuverability and visibility were scored and compared, and the irrigation flow and maximal deflection were measured in an ex vivo setting, with an empty working channel and with accessory instruments in place. Instrument durability was also reviewed.
All models demonstrated good maneuverability, with a slight advantage for the Flex-Xc. During the diagnostic procedures, failure to access the entire pyelocaliceal system occurred in 2 cases with the URF-Vo, both because of a thin caliceal infundibulum, and in 1 case with the Cobra, because of complex caliceal architecture. Regarding visibility, although the performance of the digital models was relatively similar, the fiberoptic Cobra achieved a lower score. Loss of deflection and irrigation when using the various ancillary instruments was similar for all 3 endoscopes, but the Cobra offered supplementary flow through a secondary channel. The mean deflection loss was 5% for the URF-Vo, 9% for the Flex-Xc, and 10% for the Cobra. The visual quality of the 2 digital models remained unchanged during the study; however, in the fiberoptic ureteroscope, 58 optic fibers were broken.
The latest models of flexible ureteroscopes have proved to be effective instruments for upper urinary tract endoscopic interventions. There is still room for improvement, already made possible by the technological advances.
通过主观和客观参数比较研究 3 种最新的软性输尿管镜。
在 90 例手术中评估了 3 种软性输尿管镜（Karl Storz Flex-Xc、Olympus URF-Vo 和 Wolf Cobra）。对于每种型号，20 例为肾盂肾盏结石的治疗性手术，10 例为诊断性手术。对其可操作性和可视性进行评分和比较，并在离体环境下测量冲洗流量和最大偏转度，此时工作通道为空且有附件器械。还检查了器械的耐用性。
所有模型均表现出良好的可操作性，Flex-Xc 略占优势。在诊断性手术中，URF-Vo 有 2 例因肾盂漏斗部较细而无法进入整个肾盂肾盏系统，Cobra 有 1 例因肾盂结构复杂而无法进入。关于可视性，尽管数字模型的性能相对相似，但纤维光学 Cobra 的得分较低。使用各种辅助器械时，偏转和冲洗的丢失在 3 种输尿管镜中相似，但 Cobra 通过第二通道提供额外的流量。URF-Vo 的平均偏转损失为 5%，Flex-Xc 为 9%，Cobra 为 10%。2 种数字模型的视觉质量在研究过程中保持不变；然而，在纤维光学输尿管镜中，58 根光学纤维断裂。
最新的软性输尿管镜已被证明是上尿路内镜介入的有效工具。仍有改进的空间，技术进步已经使之成为可能。
