UP055<\/p>\n
Introduction & Objectives
\nThe widespread adoption of single-use ureteroscopes (SUS) in retrograde intrarenal surgery (RIRS) has enhanced surgicalperformance but raised significant financial and environmental sustainability concerns. Some centers utilize reprocessed, reuseddisposable scopes (RDS). Flexible and navigable suction access sheath (FANS) has emerged. This study evaluated the safety,technical efficiency, and stone-free rates (SFR) of RDS when combined with FANS in a real-world multi-institutional cohort.
\nMaterials & Methods
\nData from an ethics-approved international registry (#AINU 28\/2023\/25) across 12 centers were prospectively analyzed. A total of607 adult patients with renal calculi who underwent RIRS utilizing RDS and a FANS sheath between July 2025 and March 2026were enrolled. Laser lithotripsy was performed using high-power Holmium:YAG or Thulium fiber laser systems. Patients were stratified into subgroups based on the number of prior RDS uses: 1 previous use (n=255), 2 previous uses (n=135), 3 previous uses(n=106), and \u22654 previous uses (n=111); cumulative prior usage duration: 1\u201330 min (n=233), 31\u201360 min (n=165), 61\u201390 min (n=111),and >90 min (n=97).Outcomes were 30-day SFR (no fragment) using 2 mm CT scan at 30 days and perioperative complications.
\nResults
\nThe overall cohort (n=607) had a median age of 50 years (IQR 40.5\u201360), a median stone volume of 470.9 mm\u00b3 (IQR 197.5\u2013967.0).Pre-stenting rate was 66.2%. The global median operative time was 60 min (IQR 40\u201380). Intraoperative scope malfunction requiring exchange occurred in 15.0% (n=91) of cases, driven primarily by deflection defects (56.0%) and visualization failure (33.0%).Stratification by reuse cycle demonstrated a progressive decline in technical efficiency: median operative time rose from 55.0 min at1 prior use to 65.0 min at \u22654 prior uses (p<0.0001). Correspondingly, intraoperative scope replacement rates escalated dramatically from 6.7% (1 prior use) to 39.9% (\u22654 prior uses; p<0.0001). Analysis by cumulative prior duration confirmed this trend, with scope failure increasing from 6.0% (90 min; p<0.0001). Conversely, safety endpoints remained uniform across all subgroups: 24-hour postoperative fever and sepsis were low. No patients required intensive care admission. Final 30-day Grade ASFR reached 87.5% globally and was stable across the cumulative duration groups.
\nConclusions
\nRIRS using RDS combined with FANS is a clinically feasible approach that provides high stone clearance and good safety. Due tohigh exchange rates, reusing disposable ureteroscopes beyond a cumulative duration of 60 minutes or more than 3 cycles isdiscouraged.<\/p>","protected":false},"excerpt":{"rendered":"
UP055 Introduction & Objectives The widespread adoption of single-use ureteroscopes (SUS) in retrograde intrarenal surgery (RIRS) has enhanced surgicalperformance but raised significant financial and environmental sustainability concerns. Some centers utilize reprocessed, reuseddisposable scopes (RDS). Flexible and navigable suction access sheath … read more<\/a><\/p>","protected":false},"author":3,"featured_media":189,"menu_order":0,"template":"","meta":{"_acf_changed":false},"portfolio-type":[17],"portfolio-tag":[],"class_list":["post-188","portfolio","type-portfolio","status-publish","has-post-thumbnail","hentry","portfolio-type-highlight-session-1"],"acf":[],"_links":{"self":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio\/188","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio"}],"about":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/types\/portfolio"}],"author":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/users\/3"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media\/189"}],"wp:attachment":[{"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/media?parent=188"}],"wp:term":[{"taxonomy":"portfolio-type","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-type?post=188"},{"taxonomy":"portfolio-tag","embeddable":true,"href":"https:\/\/ice26.eposter.civired.com\/en\/wp-json\/wp\/v2\/portfolio-tag?post=188"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}