Abdel Razzak O M, Bagley D H
Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia PA.
J Endourol. 1994 Dec;8(6):411-4. doi: 10.1089/end.1994.8.411.
A new ureteroscope design incorporates fiberoptic imaging bundles to replace the rod lens system in a rigid ureteroscope body. These ureteroscopes have evolved along two lines: instruments with a movable eyepiece and those with a small outer diameter (< 10F). The fiberoptic imaging bundles take up less space than the rod lens system. These ureteroscopes thus have a larger working channel than instruments of a similar outer diameter with rod lens imaging systems. Measurement of irrigation rates through a representative sample of these ureteroscopes demonstrated that gravity irrigation was adequate through the empty working channel. However, if an accessory instrument was placed in the working channel, gravity irrigation was insufficient in the smaller models. Manual irrigation was more than adequate under all conditions. The larger models now offer relatively little advantage to counter the decrease in image quality associated with the "honeycomb" fiberoptic image. Nevertheless, the more recent small ureteroscopes allow an adequate irrigant flow while accepting working instruments suitable for a variety of procedures. They thus seem to be ideal for diagnostic ureteroscopy, as they are quick and easy to use, not even requiring ureteral dilation. Furthermore, their small size does not limit their therapeutic applications; on the contrary, it expands them.
一种新型输尿管镜设计采用了光纤成像束，以取代刚性输尿管镜主体中的柱状透镜系统。这些输尿管镜沿着两条路线发展：带有可移动目镜的器械和外径较小（<10F）的器械。光纤成像束比柱状透镜系统占用的空间更小。因此，与具有柱状透镜成像系统的类似外径的器械相比，这些输尿管镜具有更大的工作通道。通过对这些输尿管镜的代表性样本进行冲洗速率测量表明，通过空的工作通道进行重力冲洗就足够了。然而，如果在工作通道中放置了辅助器械，在较小型号的输尿管镜中重力冲洗就不够了。在所有情况下，手动冲洗都绰绰有余。现在，较大型号的输尿管镜在抵消与“蜂窝状”光纤图像相关的图像质量下降方面优势相对较小。尽管如此，最新的小型输尿管镜在接受适用于各种操作的工作器械的同时，仍能实现足够的冲洗液流动。因此，它们似乎是诊断性输尿管镜检查的理想选择，因为它们使用快速简便，甚至不需要输尿管扩张。此外，它们的小尺寸并不限制其治疗应用；相反，还扩大了治疗应用范围。
