TY - JOUR
T1 - Alteration in irrigant flow and deflection of flexible ureteroscopes with Nitinol baskets
AU - Ames, Caroline D.
AU - Perrone, Juan M.
AU - Weld, Kyle J.
AU - Foyil, Kelley V.
AU - Yan, Yan
AU - Venkatesh, Ramakrishna
AU - Landman, Jaime
PY - 2006/1
Y1 - 2006/1
N2 - Background and Purpose: Introduction of an instrument into the working channel of ureteroscopes adversely affects flow and deflection. We evaluated the alterations in ureteroscope channel flow and deflection caused by available Nitinol® baskets. Materials and Methods: We compared the effects of 11 Nitinol baskets on irrigation flow and deflection of three flexible ureteroscopes (Olympus P3, ACMI DUR8, and ACMI DUR8 Elite). ANOVA was used to compare the loss of flow and deflection for each basket, with P values adjusted for multiple comparisons by the Tukey method. Results: Ureteroscope flow and deflection were progressively adversely affected by all baskets as their diameter increased. The average baseline irrigant flow (46.6 mL/min) was decreased significantly: by 78.5% (to 9.9 mL/min), with the smaller baskets (Microvasive 1.9F and Cook 2.2F) and by 99.1% (to 0.4 mL/min) with the larger baskets (ACMI 3.0F and Microvasive 3.0F). Similarly, the mean baseline upward deflection (162°) decreased by 2° (1.2%) for the Cook 2.4F N-Compass and by 20° (12.3%) for the ACMI 3.0F. Loss of downward deflection from baseline (170°) ranged from 6° (3.5%) for the Microvasive 1.9F to 17° (10%) for the Microvasive 2.6F grasping forceps. The least deterioration in flow and deflection occurred with the two smallest baskets (Microvasive 1.9F and Cook 2.2F). Conclusion: Ureteroscope irrigation flow and deflection deteriorate progressively with larger-caliber Nitinol baskets. The Microvasive 1.9F and Cook 2.2F baskets resulted in the least deterioration of irrigation and deflection metrics. However, basket size is not the only factor responsible for changes in flow and ureteroscope deflection.
AB - Background and Purpose: Introduction of an instrument into the working channel of ureteroscopes adversely affects flow and deflection. We evaluated the alterations in ureteroscope channel flow and deflection caused by available Nitinol® baskets. Materials and Methods: We compared the effects of 11 Nitinol baskets on irrigation flow and deflection of three flexible ureteroscopes (Olympus P3, ACMI DUR8, and ACMI DUR8 Elite). ANOVA was used to compare the loss of flow and deflection for each basket, with P values adjusted for multiple comparisons by the Tukey method. Results: Ureteroscope flow and deflection were progressively adversely affected by all baskets as their diameter increased. The average baseline irrigant flow (46.6 mL/min) was decreased significantly: by 78.5% (to 9.9 mL/min), with the smaller baskets (Microvasive 1.9F and Cook 2.2F) and by 99.1% (to 0.4 mL/min) with the larger baskets (ACMI 3.0F and Microvasive 3.0F). Similarly, the mean baseline upward deflection (162°) decreased by 2° (1.2%) for the Cook 2.4F N-Compass and by 20° (12.3%) for the ACMI 3.0F. Loss of downward deflection from baseline (170°) ranged from 6° (3.5%) for the Microvasive 1.9F to 17° (10%) for the Microvasive 2.6F grasping forceps. The least deterioration in flow and deflection occurred with the two smallest baskets (Microvasive 1.9F and Cook 2.2F). Conclusion: Ureteroscope irrigation flow and deflection deteriorate progressively with larger-caliber Nitinol baskets. The Microvasive 1.9F and Cook 2.2F baskets resulted in the least deterioration of irrigation and deflection metrics. However, basket size is not the only factor responsible for changes in flow and ureteroscope deflection.
UR - http://www.scopus.com/inward/record.url?scp=32044449449&partnerID=8YFLogxK
U2 - 10.1089/end.2006.20.74
DO - 10.1089/end.2006.20.74
M3 - Article
C2 - 16426138
AN - SCOPUS:32044449449
SN - 0892-7790
VL - 20
SP - 74
EP - 77
JO - Journal of Endourology
JF - Journal of Endourology
IS - 1
ER -