Department of Urology, Kyorin University School of Medicine, Tokyo, Japan.
Department of Urology, Hara Genitourinary Hospital, Kobe, Japan.
J Endourol. 2020 Jun;34(6):676-681. doi: 10.1089/end.2019.0895. Epub 2020 Apr 21.
The conventional flexible ureteroscope has limited access into the lower calix and often causes biomechanical stress to surgeons. Recently, a novel flexible ureteroscope with an omnidirectional bending tip with a joystick-type control unit (URF-Y0016; Olympus, Japan) was developed. We verified the operability and ergonomics of the URF-Y0016 compared with that of the conventional flexible ureteroscope (URF-P6) in bench models. Twenty-five medical students with no experience in performing ureteroscopic manipulation were randomly assigned to URF-Y0016 and URF-P6 leading groups in a crossover study. The task was performed using a simple model as an exploratory experiment and an artificial kidney model as an evaluation experiment. We compared the task completion times of both groups, while the factors influencing task completion time were entered into a multivariate model. The ergonomics of endourology were compared using a validated questionnaire. The task completion time in the URF-Y0016 group was significantly shorter than in the URF-P6 group ( < 0.001). The URF-Y0016 group showed no difference in task completion time between each renal calix, whereas in the URF-P6 group the task completion time in the lower calix was significantly longer than that in other calices ( < 0.001). In multivariate analysis, the model of flexible ureteroscope used significantly influenced the task completion time ( < 0.001). The ergonomics of the URF-Y0016 group were significantly better than those of the URF-P6 group ( = 0.001). URF-Y0016 may offer benefits in ureteroscopy performance over the conventional flexible ureteroscope.
传统的软性输尿管镜进入下盏的通道有限,且经常给外科医生造成生物力学压力。最近,一种新型的软性输尿管镜,具有全方位弯曲尖端和操纵杆式控制单元(URF-Y0016;奥林巴斯,日本)被开发出来。我们在台架模型中验证了 URF-Y0016 的可操作性和人机工程学性能,与传统软性输尿管镜(URF-P6)进行了比较。25 名没有进行输尿管镜操作经验的医学生被随机分配到 URF-Y0016 和 URF-P6 领先组进行交叉研究。任务使用简单模型作为探索性实验,人工肾脏模型作为评估实验进行。我们比较了两组的任务完成时间,同时将影响任务完成时间的因素输入到多变量模型中。使用经过验证的问卷比较了腔内泌尿外科的人机工程学。URF-Y0016 组的任务完成时间明显短于 URF-P6 组( < 0.001)。URF-Y0016 组在每个肾盏之间的任务完成时间没有差异,而 URF-P6 组在下部肾盏的任务完成时间明显长于其他肾盏( < 0.001)。在多变量分析中,使用的软性输尿管镜模型对任务完成时间有显著影响( < 0.001)。URF-Y0016 组的人机工程学明显优于 URF-P6 组( = 0.001)。URF-Y0016 可能在输尿管镜手术性能方面优于传统软性输尿管镜。