Abbott Joel E, Sur Roger L
Department of Urology, University of California San Diego Health System, San Diego, CA, USA -
Minerva Urol Nefrol. 2016 Dec;68(6):479-495. Epub 2016 Oct 19.
The aim of this paper was to evaluate the current technology and designs of flexible ureterorenoscopes. We will review contemporary fiberoptic and digital ureteroscopes, including a discussion on ureteroscope damage and repair, and lastly present the projected future of flexible ureterorenoscopy. Ureterorenoscopy has evolved dramatically over the past several decades, which has led to landscape reshaping of stone disease treatment and upper tract pathology. Advancements in tip control, miniaturization of scopes, introduction of a digital chip on the tip, disposable devices to augment surgery, surgical experience/familiarity and most recently single use scopes are all independent factors that have increased flexible ureterorenoscopy adoption and success. We therefore detail the aforementioned and provide a view of future innovations. A review of literature from 1980 to 2016 was performed by the two authors focusing on literature that details flexible ureterorenoscopy. Technology has significantly impacted the minimally invasive endourologic management of the urinary system. This review summarizes current literature on advances and modern technical achievements. We include a focus on new perspectives and future outlook in the field of managing upper urinary tract pathology with modern technologies. The advancements in flexible ureterorenoscopy are impressive and yet the challenges of this technology are equally daunting. Obstacles to overcome include improving durability, decreasing cost, further miniaturizing scopes size, and determining the role of single use scopes. Ongoing developments in other technology fields (such as virtual 3D imaging, wireless capsular endoscopy, robotics) continue to create both opportunities to improve the procedure but also threaten to replace ureterorenoscopy over time. This is an exciting time because of past achievements and future innovations in ureterorenoscopy.
本文旨在评估当前柔性输尿管肾镜的技术与设计。我们将回顾当代的纤维光学和数字输尿管肾镜，包括对输尿管肾镜损坏与修复的讨论，最后介绍柔性输尿管肾镜的未来发展预测。在过去几十年里，输尿管肾镜技术取得了巨大的发展，这使得结石病治疗和上尿路疾病的治疗格局发生了重塑。尖端控制的进步、内镜的小型化、尖端数字芯片的引入、用于辅助手术的一次性设备、手术经验/熟悉程度以及最近的一次性内镜，这些都是增加柔性输尿管肾镜应用和成功率的独立因素。因此，我们详细阐述上述内容，并展望未来的创新。两位作者对1980年至2016年的文献进行了回顾，重点关注详细介绍柔性输尿管肾镜的文献。技术对泌尿系统的微创腔内泌尿外科治疗产生了重大影响。本综述总结了当前关于进展和现代技术成就的文献。我们重点关注利用现代技术管理上尿路疾病领域的新观点和未来展望。柔性输尿管肾镜的进展令人印象深刻，然而这项技术面临的挑战同样艰巨。需要克服的障碍包括提高耐用性、降低成本、进一步缩小内镜尺寸以及确定一次性内镜的作用。其他技术领域（如虚拟3D成像、无线胶囊内镜、机器人技术）的不断发展，既为改进该手术创造了机会，但随着时间的推移也有可能威胁到输尿管肾镜的地位。由于输尿管肾镜过去所取得的成就以及未来的创新，这是一个令人兴奋的时代。
