This prospective single center study evaluated the feasibility, perioperative outcomes, and surgeon experience of a novel digital disposable semirigid nephroscope (Redpine™) during suction mini-percutaneous nephrolithotomy (SM-PCNL) for renal stones.
Between March 2024 and March 2025, 328 patients underwent SM-PCNL using the digital disposable nephroscope across institutions. Inclusion criteria encompassed all consenting patients with renal stones managed via prone/supine SM-PCNL (14-22 Fr suction sheath). The digital disposable scope served initially as a cystoscope to place the guidewire and later used for nephroscopy. Data collected included patient/stone characteristics, operative details (lithotripsy time, access technique), complications (Clavien-Dindo), surgeon satisfaction (5-point Likert scale), and stone-free rate (SFR). SFR was assessed via low-dose CT at 30 days (Grade A: no fragments; Grade B: ≤4 mm fragment).
Median stone diameter was 1.7 cm (IQR 1.3-2.3). Median lithotripsy and total operative times were 8 min (IQR 5-16) and 22 min (IQR 20-35), respectively. Intraoperative SFR was 96%. Surgeons reported excellent instrument satisfaction (median Likert score 1/5) for vision, ease of use, and manoeuvrability within the pelvicalyceal system. Complications were rare: major (Clavien ≥ 3) occurred in 0.9% (n = 3, including colonic injury, pleural injury, sepsis. One case developed lower pole arteriorvenous fistula, managed by arterial angioembolization. At 30 days, SFR was 100%: Grade A (no fragments) in 47.9% (n = 157) and Grade B (≤ 4 mm fragment) in 52.1% (n = 171). Reintervention (ESWL) was needed in 1.2% (n = 4) within 3 months. Scope tip damage occurred in 0.6% (n = 2).
The digital disposable nephroscope demonstrated excellent feasibility and safety in SM-PCNL, facilitating efficient stone clearance time (median 22 min), high SFR, minimal complications, and superior surgeon ergonomics. Its dual cystoscope-nephroscope functionality and plug-and-play design offer significant versatility, supporting its role in advancing minimally invasive PCNL.
World journal of urology. 2026 Apr 11*** epublish ***
Vineet Gauhar, Jaisukh Kalathia, Khi Yung Fong, Steffi Kar Kei Yuen, Bhaskar Somani, Daniele Castellani
Department of Urology, Ng Teng Fong Hospital, Singapore, Singapore., Fortune Urology Clinic, Botad, Gujarat, India., Department of General Surgery, Singapore General Hospital, Singapore, Singapore., European Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands. ., European Association of Urology Section of Endourology (ESEUT), Arnhem, The Netherlands.