Öz
Objective: The aim of this study is to compare the results of operations with re-use flexible ureterorenoscope (URS) (FLEX X2, Karl Storz ) and single-use digital URS (RP-U-C12, Redpine) and find lower cost way of retrograde intrarenal surgery (RIRS) without compromising their clinical performance.
Material and Methods: One re-use URS and one single-use digital URS were investigated with respect to operation numbers, times, laser and fluoroscopy times in operations and their effectiveness in the operations. All operations were achieved by same surgeon who has completed RIRS learning curve. Two small groups of patients (n = 63 for each group) was taken because it can be reached by one re-use URS.
Results: The clinical application of the single-use URS is of equal quality compared to re-use one. In our study one case with FLEX X2 costs 399 euros, one case with RP-U-C12 costs 51.5 euros (only ureterorenoscope and its sterilization costs). This shows us single-use URS is lower cost way of retrograde intrarenal surgery.
Conclusion: Now for our country one FLEX X2 costs as same as 41 RP-U-C12. But if you use RP-U-C12 as re-use flexible URS as we do, for one case with FLEX X2 costs nearly 8 times with RP-U-C12 costs. This shows us that RP-U-C12 has much lower cost. Our clinical evaluation showed markedly high performance for the single-use ureterorenoscope, which is comparable to the one of multi-used instruments.
Anahtar Kelimeler
Etik Beyan
This study was approved by the Sivas Cumhuriyet University Ethics Committee (Approval No: 2023-09/06, Date: 2023/09/21). Research involving human participants and/or animals All analysis performed involving human participants were in accordance with the 1964 Helsinki Declaration and its later amendments.
Destekleyen Kurum
No funding was received for conducting this study
Teşekkür
-
Kaynakça
- 1. Somani BK, Al-Qahtani SM, de Medina SD & Traxer O. Outcomes of flexible ureterorenoscopy and laser fragmentation for renal stones: comparison between digital and conventional ureteroscope. Urology. 2013;82:1017-1019 https://doi.org/10.1016/j.urology.
- 2. Gridley CM & Knudsen BE. Digital ureteroscopes: technology update. Research and reports in urology. 2017;9:19- 25, https://doi.org/10.2147/RRU.S104229
- 3. Davis NF, Quinlan MR, Browne C, Bhatt NR, Manecksha RP, D’Arcy FT et al. Single-use flexible ureteropyeloscopy: a systematic review. World J Urol. 2018;36:529-536 https://doi.org/10.1007/s00345-017-2131-4 (2018).
- 4. Legemate JD, Kamphuis GM, Freund JE, Baard J, Zanetti SP et al. Durability of Flexible Ureteroscopes: A Prospective Evaluation of Longevity, the Factors that Affect it, and Damage Mechanisms. Eur Urol Focus. 2019;5(6):1105-1111 https://doi.org/10.1016/j.euf.2018.03.001.
- 5. Carey RI, Gomez CS, Maurici G, Lynne CM, Leveillee RJ, Bird VG. Frequency of ureteroscope damage seen at a tertiary care center. J. Urol. 2006;176:607-610 https://doi.org/10.1016/j.juro.2006.03.059
- 6. Karaolides T, Bach C, Kachrilas S, Goyal A, Masood J, Buchholz N. Improving the durability of digital flexible ureteroscopes. Urology. 2013;81:717-722 https://doi.org/10.1016/j.urology.2013.01.016 (2013).
- 7. Tosoian JJ, Ludwig W, Sopko N, Mullins JK & Matlaga BR. The effect of repair costs on the profitability of a ureteroscopy program. J Endourol. 2015;29:406-409 https://doi.org/10.1089/end.2014.0435 (2015).
- 8. Taguchi K, Usawachintachit M, Tzou DT, Sherer BA, Metzler I, Isaacson D et al. Micro-Costing Analysis Demonstrates Comparable Costs for LithoVue Compared to Reusable Flexible Fiberoptic Ureteroscopes. J Endourol. 2018;32:267- 273 https://doi.org/10.1089/end.2017.0523
- 9. Mazzucchi E, Marchini GS, Berto FCG, Denstedt J, Danilovic A, Vicentini FC et al. Single-use flexible ureteroscopes: Update and perspective in developing countries. A narrative review. Int Braz J Urol. 2022;48(3):456-6.
- 10. Doizi S & Traxer O. Re: Evaluation of a Novel Single-use Flexible Ureteroscope. Eur Urol. 2017;72:152-153 https:// doi.org/10.1016/j.eururo.
- 11. Eckelman MJ, Sherman J. Environmental Impacts of the U.S. Health Care System and Effects on Public Health. PLoS One. 2016;11(6):e0157014. Published 2016 Jun 9. https://doi.org/10.1371/journal.pone.015701412.
- 12. Wenbiao L, Guohua Z, Jinchun X, Chao S, Yunhe X, Lingchao M et al. A prospective multicenter randomized controlled clinical trial study of a domestic single-use digital flexible ureteroscope versus a reusable digital flexible ureteroscope fort he treatment of upper urinary tract stones. Chin J Urol. 2022;43:5. https://doi.org/10.3760/ cma.j.cn112330-20210901-00467
- 13. So WZ, Gauhar V, Chen K, Lu J, Chua WJ, Tiong HY. An in vitro Comparative Assessment of Single-Use Flexible Ureteroscopes Using a Standardized Ureteroscopy Training Model [published correction appears in Urol Int. 2022;106(10):1089. doi: 10.1159/000525721]. Urol Int. 2022;106(12):1279-1286. https://doi. org/10.1159/000525246
Öz
Amaç: Bu çalışmanın amacı, yeniden kullanılan fleksibl üreterorenoskop (URS) (FLEX X2, Karl Storz) ve tek kullanımlık dijital URS (RP-U-C12, Redpine) ile yapılan operasyonların sonuçlarını karşılaştırmak ve klinik performanslarından ödün vermeden retrograd intrarenal cerrahinin daha düşük maliyetli bir yolunu bulmaktır.
Gereç ve Yöntemler: Bir yeniden kullanılan URS ve tek kullanımlık dijital URS’ler ile, operasyon sayıları, süreleri, lazer ve floroskopi süreleri ile operasyonlardaki etkinlikleri incelenmiştir. Tüm operasyonlar, RIRS öğrenme eğrisini tamamlamış aynı cerrah tarafından gerçekleştirilmiştir. Bir yeniden kullanılan URS ile yapılabilecek sayıda hasta grubu ile (her grup için n = 63) çalışma planlanmıştır.
Bulgular: Tek kullanımlık URS’nin klinik uygulaması, yeniden kullanılan URS ile karşılaştırıldığında eşit kalitededir. Çalışmamızda bir FLEX X2 vakasının maliyeti 399 Euro, bir RP-U-C12 vakasının maliyeti ise 51,5 Euro’dur (sadece üreterorenoskop ve sterilizasyon maliyetleri). Bu, tek kullanımlık URS’nin retrograd intrarenal cerrahinin daha düşük maliyetli bir yolu olduğunu göstermektedir.
Sonuç: Şu anki durumda, ülkemizde bir FLEX X2, 41 adet RP-U-C12’ye eşdeğer maliyetlere sahiptir. RP-U-C12’yi bizler gibi yeniden kullanılabilir fleksible URS olarak kullanırsanız, FLEX X2 ile bir vakada harcanan maliyet, RP-U-C12 ile yapılan bir vakadan yaklaşık 8 kat daha fazladır. Bu, RP-U-C12’nin çok daha düşük maliyetli olduğunu göstermektedir. Klinik değerlendirmemiz, tek kullanımlık üreterorenoskopun, çok kullanımlı aletlerle karşılaştırılabilir şekilde oldukça yüksek performans gösterdiğini ortaya koymuştur.
Anahtar Kelimeler
Etik Beyan
Bu çalışma Sivas Cumhuriyet Üniversitesi Etik Kurulu tarafından onaylanmıştır (Onay No: 2023-09/06, Tarih: 2023/09/21). İnsan katılımcıları ve/veya hayvanları içeren araştırmalar İnsan katılımcıları içeren tüm analizler 1964 Helsinki Bildirgesi ve sonraki değişikliklerine uygun olarak gerçekleştirilmiştir.
Destekleyen Kurum
Yok
Kaynakça
- 1. Somani BK, Al-Qahtani SM, de Medina SD & Traxer O. Outcomes of flexible ureterorenoscopy and laser fragmentation for renal stones: comparison between digital and conventional ureteroscope. Urology. 2013;82:1017-1019 https://doi.org/10.1016/j.urology.
- 2. Gridley CM & Knudsen BE. Digital ureteroscopes: technology update. Research and reports in urology. 2017;9:19- 25, https://doi.org/10.2147/RRU.S104229
- 3. Davis NF, Quinlan MR, Browne C, Bhatt NR, Manecksha RP, D’Arcy FT et al. Single-use flexible ureteropyeloscopy: a systematic review. World J Urol. 2018;36:529-536 https://doi.org/10.1007/s00345-017-2131-4 (2018).
- 4. Legemate JD, Kamphuis GM, Freund JE, Baard J, Zanetti SP et al. Durability of Flexible Ureteroscopes: A Prospective Evaluation of Longevity, the Factors that Affect it, and Damage Mechanisms. Eur Urol Focus. 2019;5(6):1105-1111 https://doi.org/10.1016/j.euf.2018.03.001.
- 5. Carey RI, Gomez CS, Maurici G, Lynne CM, Leveillee RJ, Bird VG. Frequency of ureteroscope damage seen at a tertiary care center. J. Urol. 2006;176:607-610 https://doi.org/10.1016/j.juro.2006.03.059
- 6. Karaolides T, Bach C, Kachrilas S, Goyal A, Masood J, Buchholz N. Improving the durability of digital flexible ureteroscopes. Urology. 2013;81:717-722 https://doi.org/10.1016/j.urology.2013.01.016 (2013).
- 7. Tosoian JJ, Ludwig W, Sopko N, Mullins JK & Matlaga BR. The effect of repair costs on the profitability of a ureteroscopy program. J Endourol. 2015;29:406-409 https://doi.org/10.1089/end.2014.0435 (2015).
- 8. Taguchi K, Usawachintachit M, Tzou DT, Sherer BA, Metzler I, Isaacson D et al. Micro-Costing Analysis Demonstrates Comparable Costs for LithoVue Compared to Reusable Flexible Fiberoptic Ureteroscopes. J Endourol. 2018;32:267- 273 https://doi.org/10.1089/end.2017.0523
- 9. Mazzucchi E, Marchini GS, Berto FCG, Denstedt J, Danilovic A, Vicentini FC et al. Single-use flexible ureteroscopes: Update and perspective in developing countries. A narrative review. Int Braz J Urol. 2022;48(3):456-6.
- 10. Doizi S & Traxer O. Re: Evaluation of a Novel Single-use Flexible Ureteroscope. Eur Urol. 2017;72:152-153 https:// doi.org/10.1016/j.eururo.
- 11. Eckelman MJ, Sherman J. Environmental Impacts of the U.S. Health Care System and Effects on Public Health. PLoS One. 2016;11(6):e0157014. Published 2016 Jun 9. https://doi.org/10.1371/journal.pone.015701412.
- 12. Wenbiao L, Guohua Z, Jinchun X, Chao S, Yunhe X, Lingchao M et al. A prospective multicenter randomized controlled clinical trial study of a domestic single-use digital flexible ureteroscope versus a reusable digital flexible ureteroscope fort he treatment of upper urinary tract stones. Chin J Urol. 2022;43:5. https://doi.org/10.3760/ cma.j.cn112330-20210901-00467
- 13. So WZ, Gauhar V, Chen K, Lu J, Chua WJ, Tiong HY. An in vitro Comparative Assessment of Single-Use Flexible Ureteroscopes Using a Standardized Ureteroscopy Training Model [published correction appears in Urol Int. 2022;106(10):1089. doi: 10.1159/000525721]. Urol Int. 2022;106(12):1279-1286. https://doi. org/10.1159/000525246
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Üroloji |
| Bölüm | Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Mayıs 2025 |
| Gönderilme Tarihi | 10 Aralık 2024 |
| Kabul Tarihi | 21 Mart 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 17 Sayı: 2 |
