Abstract
All three basket devices when introduced through a 3.6F channel adversely affected the flow of irrigation and scope deflection. As one may expect, the 1.3F basket produced less effect on the irrigation flow and scope deflection compared with the 1.5F basket. Compared with the 1.5F basket, the 1.3F basket produced approximately 2 to 3 degrees (43%) less loss of scope deflection and approximately 8 to 9 mL/min (28%) better flow. The authors note the above differences as statistically significant. It is also likely to be clinically significant in certain situations in which small differences in deflection or flow can result in either a successful or a failed procedure. Use of smaller baskets may potentially result in higher stone-free rates for the ureteroscopic approach.
Among the three most common treatment modalities for patients with urolithiasis (shockwave lithotripsy, percutaneous nephrolithotomy, and ureteroscopic lithotripsy), the most siginificant technologic evolution over the last decade has been in the field of ureteroscopic instrumentation. Not surprisingly, flexible ureteroscopic lithotripsy for renal stone disease is increasing because this has made possible the treatment of even complex caliceal stones efficaciously in an outpatient setting. Other potential additions, such as the dual-channel flexible ureteroscope (providing constant flow of irrigation without interference by working channel instrumentation), and application of the robotic platform may provide additional armamentarium to flexible ureteroscopic technology. 2,3