AUA 2017: Limitations of the Lithovue Single Use Digital Flexible Ureteroscope

Boston, MA ( Urologists from USC describe their initial experience with the Boston Scientific Corp. Lithovue™ Single-Use Digital Flexible Ureteroscope. The ureteroscope was studied in cases of ureteroscopic treatment of renal stone, ureteral stricture, and upper urinary tract disease.

Two cases of mechanical failure were reported; however, both were noted prior to their respective procedure. For visualization, optic interference was experienced during treatment of dense calcium oxalate based stones, and interestingly, during electrocautery. In cases that required electrocautery, complete “white-out” of the video screen was reported, and this did not change with advancement of the electrode further from the distal end of the ureteroscope. This phenomenon is also experienced with conventional reuable digital flexible ureteroscopes. Electrocautery interference may be attributed to the presence of the video chip on the distal end of the ureteroscope and its proximity to the electrode. Additionally, issues with depth perception were experienced when treating ureteral stricture and identifying the true lumen.

Overall, their review endorsed the use of Lithovue™ for routine laser lithotripsy, however for cases of complex upper urinary tract disease, use of the Lithovue™ may be suboptimal. Studies evaluating the Lithovue™ at the University of California San Francisco, note comparable procedural and maintenance cost to that of re-usable ureteroscopes (i.e. Storz Flex-X2), which merit further studies of single-use ureteroscopes. Ultimately, prospective randomized studies are required to fully study the Lithovue™ and identify its place in endoscopic urologic surgery.

Presented by: Dr. Eli Thompson, MD

Authors: Saum Ghodossipour, Eli Thompson, Adit Shah, Anirban Mitra, Sameer Deshmukh, Matthew Dunn

Affiliation: University of Southern California (USC), Los Angeles, CA

Written By: Daniel Lama for

at the 2017 AUA Annual Meeting - May 12 - 16, 2017 – Boston, Massachusetts, USA