Revolutionary Ureteroscopy Technique Enhances Stone Removal and Safety

What is it about?

Direct in-scope suction (DISS) ureteroscopy is an innovative technology that integrates suction into the ureteroscope to enhance stone clearance, improve visibility, and reduce intrarenal pressure during ureteroscopic stone surgery. DISS ureteroscopes come in single-channel or dual-channel designs, with dual-channel allowing simultaneous irrigation and suction, potentially reducing infection risk and laser injury. They may not require a ureteric access sheath and provide stone-free rates similar to traditional methods without increasing complications. However, performance varies with device size, flexibility, and suction power, and challenges like deflection limitations and risk of clogging exist. DISS is particularly advantageous for patients with moderate-to-large stone burdens, and future advancements like integrated suction-laser tools are expected to further enhance its capabilities. Despite the promising benefits, high-quality research is needed to substantiate these findings.

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Why is it important?

This research is important as it provides an overview of direct in-scope suction (DISS) ureteroscopy, a novel technology in endourology that seeks to address the limitations of conventional ureteroscopy. By integrating suction directly into the ureteroscope, DISS aims to improve stone clearance, enhance visualization, and maintain intrarenal pressure during ureteroscopic stone surgeries. This can significantly reduce the risk of complications and improve surgical outcomes, particularly for patients with a high stone burden. The findings highlight the potential of DISS to transform standard practices in ureteroscopy and the need for further high-quality evidence to validate its benefits and optimize its use in clinical settings. Key Takeaways: 1. Enhanced Stone Management: The integration of suction within the ureteroscope allows for more efficient stone fragment evacuation, potentially reducing the need for secondary procedures and improving stone-free rates without increasing major complications. 2. Improved Intrarenal Pressure Control: DISS actively manages intrarenal pressure, which may lower the risk of infectious complications and inadvertent laser injury, offering a significant advantage over traditional ureteroscopy methods. 3. Technological Advancements: Emerging technologies, such as integrated suction-laser tools and pressure-monitoring systems, promise to further expand the capabilities of DISS, making it a promising evolution in the field of endourology.