Stone Clearance: Testing New Suction Methods in Ureteroscopy

What is it about?

This research describes a study comparing the effectiveness of direct in-scope suction (DISS) ureteroscopes and flexible and navigable suction (FANS) ureteric access sheaths in clearing stones of various sizes. The researchers conducted benchtop experiments using quartz stones as surrogates for renal stones, testing progressively larger particle sizes. DISS ureteroscopes with 3.6-Ch and 5.1-Ch working channels were able to clear stones up to 250 μm and 500 μm, respectively. FANS, however, successfully cleared all stone sizes tested, up to 2000 μm. The study concluded that while DISS can effectively aspirate smaller "dust" particles during laser lithotripsy, FANS may be more suitable for clearing larger fragments due to its larger working channel. This research aims to improve stone-free rates in ureteroscopy procedures by evaluating different suction technologies.

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Photo by Amit Gaur on Unsplash

Photo by Amit Gaur on Unsplash

Why is it important?

This research is significant because it evaluates the effectiveness of different ureteroscopic suction techniques for clearing kidney stone fragments. Understanding the capabilities and limitations of direct in-scope suction (DISS) ureteroscopes and flexible and navigable suction (FANS) ureteric access sheaths is crucial for improving stone clearance during ureteroscopy procedures. This knowledge can help urologists choose the most appropriate tools and techniques for different stone sizes, potentially leading to improved stone-free rates, reduced procedure times, and better patient outcomes in the treatment of urinary stone disease. Key Takeaways: 1. Suction Capabilities: DISS ureteroscopes can effectively clear smaller stone particles (up to 250-500 μm), while FANS access sheaths demonstrate superior efficacy in clearing larger fragments (up to 2000 μm), highlighting the importance of tool selection based on stone size. 2. Working Channel Impact: The size of the working channel significantly affects the maximum stone particle size that can be cleared, with larger channels allowing for the passage of bigger fragments. 3. Clinical Implications: Understanding the limitations of different suction techniques can help urologists optimize their approach during laser lithotripsy, potentially improving stone clearance and reducing the risk of scope blockage during procedures.