Department of Urology, Miller School of Medicine, University of Miami, Miami, Florida, USA.
J Endourol. 2021 Mar;35(3):289-295. doi: 10.1089/end.2020.0709. Epub 2021 Jan 29.
Published literature on damages to a digital flexible ureteroscope (DFU) examines a limited number of ureteroscopes and shows wide variation in its durability. The aim of this study was to compare the primary damage location, causes of DFU damages, and the durability of Karl Storz Flex-Xc digital ureteroscope between University Hospital (UH) and Ambulatory Care Surgery Center (ASC). We also evaluated the available literature on the durability of DFU. Each damaged DFU prospectively underwent a manufacturer's evaluation to determine the reason for return and primary site of damage. Hospital data on the number of ureteroscopic procedures and damaged DFUs over 3 years were retrospectively reviewed. The possible reason for the damage was classified as either intraoperative or between the procedures. The durability of DFUs, type, and cause of damage were compared between the UH and nonteaching ASC. A chi-square test was utilized for categorical variables. When cell frequencies were <5, Fisher's exact test was used. During the study period, 1211 ureteroscopies were performed and 143 ureteroscopes were returned to the manufacturer. The mean number of uses was 7.45 at the UH and 16.5 at the ASC. The location and cause of damage were similar at both locations. The most common locations of primary damage were at the angle cover (70.6%) and instrument channel (19.2%). Most damage occurred during the handling of the ureteroscopes between surgical procedures (78%). On review of the literature, we found that DFUs were 6 times more durable in a nonteaching hospital. The DFU was more than two times as durable in the ASC as in the UH. Most incidents occurred during handling between surgical procedures. Future research is needed to examine the impact of training and certification of support staff on durability of DFUs.
已发表的关于数字软性输尿管镜（DFU）损坏的文献研究了有限数量的输尿管镜，并显示其耐用性差异很大。本研究的目的是比较大学医院（UH）和门诊手术中心（ASC）之间 Karl Storz Flex-Xc 数字输尿管镜的主要损坏部位、DFU 损坏的原因以及耐用性。我们还评估了关于 DFU 耐用性的现有文献。 每个损坏的 DFU 都前瞻性地进行了制造商评估，以确定退货原因和主要损坏部位。回顾性审查了 3 年来医院关于输尿管镜检查程序数量和损坏的 DFU 的数据。将损坏的可能原因分类为手术期间或手术之间。比较 UH 和非教学 ASC 之间 DFU 的耐用性、类型和损坏原因。使用卡方检验进行分类变量。当单元格频率<5 时，使用 Fisher 精确检验。 在研究期间，进行了 1211 例输尿管镜检查，有 143 例输尿管镜返回制造商。UH 的平均使用次数为 7.45，ASC 为 16.5。两个地点的损坏位置和原因相似。主要损坏的最常见部位是角度盖（70.6%）和器械通道（19.2%）。大多数损坏发生在手术之间处理输尿管镜期间（78%）。在对文献的回顾中，我们发现非教学医院的 DFU 耐用性提高了 6 倍。DFU 在 ASC 的耐用性是 UH 的两倍多。大多数事件发生在手术之间处理过程中。需要进一步研究以检查支持人员的培训和认证对 DFU 耐用性的影响。
