Login to Access Video or Poster Abstract: MP50-08
Sources of Funding: None

Introduction

A new disposable flexible digital ureteroscope (Lithovue, Boston Scientific, Marlborough, Mass) was recently released as an alternative to nondisposable digital scopes. This series reviews our initial experience with this new device with a focus on identifying its limitations.

Methods

We retrospectively reviewed our first 75 cases with the 7.7Fr disposable flexible digital ureteroscope and identified any problems, difficulties, or complications related to the scope itself.

Results

Of the 75 patients, 47 were female 28 were male; 39 cases were left sided, 30 were right sided, and 6 were bilateral. The reasons for ureteroscopy include stone disease in 60 pts, ureteral stricture disease in 5 patients, and upper tract transitional cell carcinoma (TCC) in 10 patients. There was difficulty in getting up the ureter (ureterovesical junction) in 3 patients; one due to distal ureteral narrowing requiring balloon dilation, the other 2 due to proximal ureter narrowing requiring stenting. Passage of the scope was relatively effortless in the remaining retrograde URS patients. Two patients underwent antegrade ureteroscopy through an established nephrostomy tract to treat ureteroenteric anastomotic strictures. _x000D_ There was mild interference in the video system during laser lithotripsy of hard stones (calcium oxalate monohydrate but did not prevent treatment. But the system was incompatible with the use of electrocautery. During fulguration of upper tract TCC, the system continually shut down during the use of a 3Fr electrode. Another difficulty with visualization occurred during antegrade ureteroscopy for 2 ureteroileal anastomotic strictures. Due to problems with distant focusing, there was difficulty identifying the true lumen past the stricture, which lead to inaccurate incision of the soft tissue resulting in extravasation in both cases. _x000D_

Conclusions

This new disposable ureteroscope works well for routine ureteroscopy with laserlithotripsy but should not be used with electrocautery and avoided for antegrade incision of ureteroenteric anastomotic strictures. Its strength is in near focusing rather than distant focusing which is fine for stones but not for the latter situation.

Funding

None