Bechis Seth K, Abbott Joel E, Sur Roger L
Department of Urology, University of California San Diego, La Jolla, CA, USA.
Chesapeake Urology Associates, University of Maryland Baltimore, Baltimore, MD, USA.
Transl Androl Urol. 2017 Dec;6(6):1144-1149. doi: 10.21037/tau.2017.11.30.
To compare head to head two end-engaging nitinol stone retrieval devices available to urologists, in terms of durability, versatility and efficacy.
For durability testing, 30 NGage and Dakota baskets were cycled 20 times between grasping and releasing synthetic stone models and evaluated for damage or device failure. For versatility and efficacy testing, baskets were assessed in their ability to capture and release stone models from 1 to 11 mm. Each stone was raised above the capture site and the basket was opened to passively release the stone. If the stone did not release, the basket handle was shaken and the OpenSure feature employed if needed. Manual release was used as a last resort.
Durability-the Cook NGage demonstrated a statistically significant increased rate of visible device breakdown (P=0.0046) in 8 of 30 (26.7%) devices 0 of 30 Dakota devices, with mean damage at 13.5 cycles. Versatility and efficacy-both 8 mm baskets successfully captured stones from 1-8 mm. The Dakota more effectively released 7-8 mm stones (P<0.0001). NGage required manual release of 8 mm stones in 13 cases compared to none with Dakota. For 11 mm baskets, the Dakota released all stones up to 10 mm with simple opening, while the NGage released 10 of 15 (67%) of 9 mm stones and 1 of 15 (7%) of 10 mm stones by simple opening. For 11 mm stones, the Dakota captured 100% whereas NGage could not capture any.
Both baskets showed similar durability characteristics. The Dakota basket more effectively captured and released stones over 7 mm, as compared to the NGage basket. The OpenSure aspect conferred an advantage in handling and release of larger stones. These results demonstrate potential versatility, durability and efficacy of the Dakota basket.
为了在耐用性、多功能性和有效性方面，对泌尿外科医生可用的两种头部接合镍钛诺结石取出装置进行直接比较。
对于耐用性测试，30个NGage篮筐和达科他篮筐在抓取和释放合成结石模型之间循环20次，并评估是否有损坏或装置故障。对于多功能性和有效性测试，评估篮筐捕捉和释放1至11毫米结石模型的能力。将每颗结石提升到捕捉部位上方，打开篮筐以被动释放结石。如果结石没有释放，摇晃篮筐手柄，并在需要时使用OpenSure功能。最后才采用手动释放。
耐用性——Cook NGage在30个装置中的8个（26.7%）出现可见装置故障的发生率有统计学意义的增加（P=0.0046），而30个达科他装置中为0个，平均损坏发生在13.5个循环时。多功能性和有效性——两个8毫米的篮筐都成功捕捉了1至8毫米的结石。达科他更有效地释放了7至8毫米的结石（P<0.0001）。NGage在13例中需要手动释放8毫米的结石，而达科他则无需手动释放。对于11毫米的篮筐，达科他通过简单打开就能释放所有达10毫米的结石，而NGage通过简单打开只能释放15个9毫米结石中的10个（67%）和15个10毫米结石中的1个（7%）。对于11毫米的结石，达科他的捕捉率为100%，而NGage无法捕捉任何结石。
两种篮筐显示出相似的耐用性特征。与NGage篮筐相比，达科他篮筐在捕捉和释放7毫米以上的结石方面更有效。OpenSure功能在处理和释放较大结石方面具有优势。这些结果证明了达科他篮筐具有潜在的多功能性、耐用性和有效性。
