The conventional flexible ureteroscope has limited access into the lower calyx and often causes biomechanical stress to surgeons. Recently, a novel flexible ureteroscope with an omnidirectional bending tip with a joystick-type control unit (URF-Y0016; Olympus, Japan) was developed. We verified the operability and ergonomics of the URF-Y0016 compared to that of the conventional flexible ureteroscope (URF-P6) in bench models.
Twenty-five medical students with no experience in performing ureteroscopic manipulation were randomly assigned to URF-Y0016 and URF-P6 leading groups in a crossover study. The task was performed using a simple model as an exploratory experiment and an artificial kidney model as an evaluation experiment. We compared the task completion times of both groups, while the factors influencing task completion time were entered into a multivariate model. The ergonomics of endourology were compared using a validated questionnaire.
The task completion time in the URF-Y0016 group was significantly shorter than in the URF-P6 group (p <0.001). The URF-Y0016 group showed no difference in task completion time between each renal calyx, whereas in the URF-P6 group, the task completion time in the lower calyx was significantly longer than that in other calices (p <0.001). In multivariate analysis, the model of flexible ureteroscope used significantly influenced the task completion time (p <0.001). The ergonomics of the URF-Y0016 group were significantly better than those of the URF-P6 group (p = 0.001).
URF-Y0016 may offer benefits in ureteroscopy performance over the conventional flexible ureteroscope.
Journal of endourology. 2020 Jan 26 [Epub ahead of print]
Mitsuhiro Tambo, Takaaki Inoue, Hiroyasu Miura, Junichi Matsuzaki, Kikuo Nutahara, Shuzo Hamamoto, Shinsuke Okada, Hiroshi Fukuhara, Masato Fujisawa, Tadashi Matsuda
Kyorin University, School of Medicine, urology, 6-20-2, Shinkawa, Mitaka, Tokyo, Mitaka, Japan, 181-8611; ., Hara Genitourinary Hospital, Urology, kobe city, Japan., Hachinohe Koyo Clinic, Urology, Hachinohe, Japan; ., Ohguchi East General Hospital, Urology, 2-19-1 Irie, Kanagawa Ward, Yokohama city, Yokohama, Japan, 221-0014; ., Bremen Street Urology & Nephrology Clinic, Kawasaki, Japan; ., Nagoya City University Graduate School of Medical Sciences, Nephro-urology, 1 Kawasumi, Mizuho-ku, Mizuho-cho, Nagoya, Japan, 467-8601; ., Gyotoku General Hospital, Urology, Ichikawa, Japan; ., Kyorin University School of Medicine, Urology, Tokyo, Japan; ., Kobe University School of Medicine, Urology, Kobe, Japan; ., Kansai Medical University, Department of Urology and Andrology, Shinmachi 2-5-1, Hirakata, Osaka, Japan, 573-1010; .