Morgan Kevin N, Terry Russell S, Holloway Alec R, Krishingner G Austin, George Kevin A, Massari Michael, Canales Benjamin K, Bird Vincent G, DiBianco John Michael
Florida Urology Partners, 16513 US-301, Wimauma, Tampa, FL, 33598, USA.
Department of Urology, University of Florida, Gainesville, FL, USA.
World J Urol. 2025 May 5;43(1):269. doi: 10.1007/s00345-025-05516-5.
Fluid irrigation is critical for adequate visualization during transurethral endoscopic surgery. There is a paucity of data comparing irrigation by resectoscope, working tools, or fluid system. This study aims to measure flow rate through four different resectoscopes with varying working channel configurations and irrigation systems to compare different configurations of clinical equipment used during laser endoscopic enucleation of the prostate (LEEP).
MATERIALS/METHODS: We measured irrigation flow rates through four different sized resectoscopes with three different working channel configurations using five different irrigation systems in a benchtop model. Irrigation was run through each equipment configuration for 30 s in duplicate, and flow rate was calculated.
One hundred measurements were performed in 50 different equipment configurations. From fastest to slowest, resectoscope flow rates were as follows: 28Fr Storz, 26Fr Storz, 26Fr Wolf, and 24.5Fr Wolf (p < 0.0001) with no statistically significant difference seen among the three working channel configurations. From fastest to slowest, irrigation system flow rates were as follows: 150 cm Y-tubing, 150 cm Level-1, 100 cm Y-tubing, 100 cm Level-1, and Thermedx 60 mm Hg (p < 0.0001). Comparing irrigation systems, within group standard deviations were low except in the 100 cm and 150 cm Level-1 systems (SD 53.7 and 56.6mL/min respectively).
Resectoscope irrigation followed the principles of fluid dynamics, with larger caliber scopes providing greater flow independently of working equipment selections. Despite the inconsistencies seen with the Level-1, higher pressure irrigation resulted in faster flow across all equipment configurations. Future studies with larger sample sizes are necessary to understand if these findings are reproducible and clinically impactful.
在经尿道内镜手术中，液体冲洗对于获得充分的视野至关重要。关于通过电切镜、操作工具或液体系统进行冲洗的比较数据较少。本研究旨在测量通过四种不同的、具有不同工作通道配置和冲洗系统的电切镜的流速，以比较在激光前列腺剜除术（LEEP）期间使用的临床设备的不同配置。
材料/方法：我们在台式模型中，使用五种不同的冲洗系统，测量了通过四种不同尺寸、具有三种不同工作通道配置的电切镜的冲洗流速。每种设备配置重复进行冲洗30秒，并计算流速。
在50种不同的设备配置下进行了100次测量。从最快到最慢，电切镜的流速如下：28Fr史托斯电切镜、26Fr史托斯电切镜、26Fr狼牌电切镜和24.5Fr狼牌电切镜（p＜0.0001），三种工作通道配置之间未见统计学显著差异。从最快到最慢，冲洗系统的流速如下：150cm Y型管、150cm一级冲洗系统、100cm Y型管、100cm一级冲洗系统和Thermedx 60mmHg（p＜0.0001）。比较冲洗系统，除了100cm和150cm一级冲洗系统外（标准差分别为53.7和56.6mL/分钟），组内标准差较低。
电切镜冲洗遵循流体动力学原理，较大口径的电切镜独立于操作设备选择提供更大的流速。尽管一级冲洗系统存在不一致性，但较高压力的冲洗在所有设备配置中都导致更快的流速。需要进行更大样本量的未来研究，以了解这些发现是否可重复且具有临床意义。
