Pd10-08 a Randomized, Cost-Effectiveness Study of New-Generation Digital Reusable vs. Single-Use Flexible Ureteroscopes for Endoscopic Combined Intrarenal Surgery

You have accessJournal of UrologyStone Disease: Surgical Therapy (including ESWL) II (PD10) 1 May 2024PD10-08 A RANDOMIZED, COST-EFFECTIVENESS STUDY OF NEW-GENERATION DIGITAL REUSABLE VS. SINGLE-USE FLEXIBLE URETEROSCOPES FOR ENDOSCOPIC COMBINED INTRARENAL SURGERY Kazumi Taguchi, Shuzo Hamamoto, Takahiro Yanase, Ryosuke Chaya, Kengo Kawase, Teruaki Sugino, Rei Unno, Yohei Takakura, Shiori Tajima, Atsushi Okada, and Takahiro Yasui Kazumi TaguchiKazumi Taguchi, Shuzo HamamotoShuzo Hamamoto, Takahiro YanaseTakahiro Yanase, Ryosuke ChayaRyosuke Chaya, Kengo KawaseKengo Kawase, Teruaki SuginoTeruaki Sugino, Rei UnnoRei Unno, Yohei TakakuraYohei Takakura, Shiori TajimaShiori Tajima, Atsushi OkadaAtsushi Okada, and Takahiro YasuiTakahiro Yasui View All Author Informationhttps: //doi. org/10. 1097/01. JU. 0001008748. 59024. cb. 08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: With the rise in innovation in flexible ureteroscopes, such as digital reusable and single-use scopes, selecting the optimal equipment both clinically and economically remains challenging. Our study aimed to provide a cost-benefit analysis through a randomized controlled trial (RCT) comparing the latest generation digital reusable (URF-V3) with single-use (Uscope PU3033A and WiScope) flexible ureteroscopes during complex endoscopic combined intrarenal surgeries (ECIRS). METHODS: This single-center, cost-effectiveness RCT spanned from September 2021 to September 2023. Patients with significant renal stone burdens undergoing ECIRS were recruited and assigned to either the V3 or single-use groups. Five brand-new V3 scopes, acquired exclusively for this study, were used. A 17. 5 Fr tract predominantly facilitated percutaneous lithotomy, and simultaneous Ho: YAG laser lithotripsy was executed via the ureteroscope. Primary endpoints were the cost per procedure and scope durability, while secondary outcomes encompassed stone-free rates, surgical duration, and complications. RESULTS: 135 ECIRS procedures were recorded. No significant clinical differences were observed between the groups. The study noted two repairs for V3 scopes and four breakages for single-use scopes. Cost per case stood at 840 for single-use and 1, 815 for the V3 group. The V3 scopes endured between 23 and 34 cases before needing repair. A break-even point of 170 cases was determined to equate the costs of single-use scopes with five new V3 scopes. The single-use group exhibited higher total laser energy usage and lower ureteroscopy-assisted percutaneous access. Notably, there was a trend toward improved stone-free rates in the single-use group. Damaged scope incidents correlated with larger stone sizes and higher stone-free rates, as well as prolonged surgical and laser durations. (Table 1) CONCLUSIONS: The study highlights the economic benefits and potential for enhanced stone clearance when using single-use flexible ureteroscopes in ECIRS. While intensive use of these ureteroscopes may elevate the risk of breakage, it also facilitates improved stone clearance. A hybrid approach, combining both reusable and single-use scopes, may offset the economic implications. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc. FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e188 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc. Metrics Author Information Kazumi Taguchi More articles by this author Shuzo Hamamoto More articles by this author Takahiro Yanase More articles by this author Ryosuke Chaya More articles by this author Kengo Kawase More articles by this author Teruaki Sugino More articles by this author Rei Unno More articles by this author Yohei Takakura More articles by this author Shiori Tajima More articles by this author Atsushi Okada More articles by this author Takahiro Yasui More articles by this author Expand All Advertisement PDF downloadLoading. . .