Aso Y, Takayasu H, Ohta N, Tajima A
Department of Urology, Faculty of Medicine, University of Tokyo, Japan.
Urol Clin North Am. 1988 Aug;15(3):329-38.
The clinical applications of flexible ureterorenoscopes have fallen behind those of their rigid counterparts. Flexible endoscopes that possess a working channel and can also be employed for treatment have at last been developed. This instrument is particularly effective in the treatment of stones in the upper urinary tract, as it can easily follow mobile upper ureteral stones and calculi in the middle or lower renal calices, which are not as accessible with a rigid endoscope. It is important to remember not to exert too much force when inserting the instrument into the ureter, renal pelvis, or renal calices, and, if one remains calm, should the visual field become temporarily obscured, there should be little danger of damaging these structures. This method will probably be increasingly employed, not only for the treatment of stones in the upper urinary tract, but also for the removal of foreign bodies and the diagnosis and treatment of small pathologic conditions or lesions such as carcinoma in situ in which the roentgenologic presentation is unclear. For this expansion of instrument use to be ensured, it is necessary to improve the resolution of the fiberoptic endoscope image and increase the instrument's angulation capabilities, increase the range of accessories that can be employed with it, and also increase familiarity with the instruments on the part of urologists.
可弯曲输尿管肾镜的临床应用落后于其刚性同类产品。最终开发出了具有工作通道且可用于治疗的可弯曲内窥镜。该器械在上尿路结石治疗中特别有效，因为它能够轻松追踪活动的上段输尿管结石以及中、下肾盏结石，而刚性内窥镜难以触及这些部位。重要的是要记住，在将器械插入输尿管、肾盂或肾盏时不要用力过猛，并且，如果保持冷静，即使视野暂时模糊，损伤这些结构的风险也很小。这种方法可能会越来越多地被采用，不仅用于治疗上尿路结石，还用于取出异物以及诊断和治疗一些X线表现不明确的小病变或病症，如原位癌。为确保该器械的应用范围得以扩展，有必要提高纤维内窥镜图像的分辨率，增加器械的角度调节能力，增加可与之配套使用的附件种类，同时提高泌尿外科医生对该器械的熟悉程度。
