COMPARISON OF OPERATIVE EFFICIENCY AND EFFECTIVENESS BETWEEN A DUAL LUMEN AND SINGLE LUMEN URETEROSCOPE FOR URETEROSCOPIC STONE REMOVAL

You have accessJournal of UrologyCME1 May 2022MP44-17 COMPARISON OF OPERATIVE EFFICIENCY AND EFFECTIVENESS BETWEEN A DUAL LUMEN AND SINGLE LUMEN URETEROSCOPE FOR URETEROSCOPIC STONE REMOVAL Andrew Brevik, Rohit Bhatt, Kalon Morgan, Sohrab Ali, Akhil Peta, Sina Zarandi, Luke Limfueco, Rajiv Karani, Lillian Xie, Raphael Arada, John Sung, Francis Jefferson, Egor Parkhomenko, Daniel Lama, Shoaib Safiullah, Pengbo Jiang, Roshan Patel, Ralph Clayman, and Jaime Landman Andrew BrevikAndrew Brevik More articles by this author , Rohit BhattRohit Bhatt More articles by this author , Kalon MorganKalon Morgan More articles by this author , Sohrab AliSohrab Ali More articles by this author , Akhil PetaAkhil Peta More articles by this author , Sina ZarandiSina Zarandi More articles by this author , Luke LimfuecoLuke Limfueco More articles by this author , Rajiv KaraniRajiv Karani More articles by this author , Lillian XieLillian Xie More articles by this author , Raphael AradaRaphael Arada More articles by this author , John SungJohn Sung More articles by this author , Francis JeffersonFrancis Jefferson More articles by this author , Egor ParkhomenkoEgor Parkhomenko More articles by this author , Daniel LamaDaniel Lama More articles by this author , Shoaib SafiullahShoaib Safiullah More articles by this author , Pengbo JiangPengbo Jiang More articles by this author , Roshan PatelRoshan Patel More articles by this author , Ralph ClaymanRalph Clayman More articles by this author , and Jaime LandmanJaime Landman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002610.17AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Dual lumen flexible ureteroscopes (DLFU) have yet to be compared head-to-head in a clinical trial with single lumen flexible ureteroscopes (SLFU). Our prospective, randomized study sought to evaluate the efficacy, efficiency, and surgeon device preference during upper urinary tract stone management with SLFU vs. DLFU. METHODS: Seventy-nine patients undergoing flexible ureteroscopy and laser lithotripsy for proximal ureteral or renal stones between 2016 and 2020 were randomized to either SLFU or DLFU. The overall time for ureteroscopy, laser lithotripsy, and stone basketing were recorded. Procedural efficiency and effectiveness based on stone clearance rate and stone-free status were calculated using preoperative and postoperative computed tomography (CT) imaging and 3D Slicer CT-based, stone volume determination. Postoperative surgeon surveys addressed ergonomics and overall ureteroscope performance. RESULTS: Although linear stone burden was not statistically different between the two groups, preoperative stone volume was almost two-fold greater in the dual lumen group (267 mm3 vs. 132 mm3, p = 0.03). Despite the larger stone volume, DLFU provided a 4-minute shorter lithotripsy time than SLFU (2 min vs. 6 min, p = 0.02) with a significantly better stone clearance rate (7.1 mm3/min vs. 3.7 mm3/min, p = 0.03). True stone-free rate, specifically a complete absence of stone fragments as seen on postoperative CT, was 48% for DLFU compared to 26% for SLFU (p = 0.05). The dual lumen exceeded the single lumen ureteroscope in all surgeon-evaluated performance metrics. CONCLUSIONS: DLFU surpassed SLFU in surgical efficiency and effectiveness by providing a faster lithotripsy procedure and a higher absolute stone-free rate. Based on surgeon questionnaires, DLFU was also ergonomically superior to SLFU. Source of Funding: The UCI Urology Curiosity and Innovation Laboratory has received support from Richard Wolf Endoscopy® in the form of funding and ureteroscopes © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e759 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Andrew Brevik More articles by this author Rohit Bhatt More articles by this author Kalon Morgan More articles by this author Sohrab Ali More articles by this author Akhil Peta More articles by this author Sina Zarandi More articles by this author Luke Limfueco More articles by this author Rajiv Karani More articles by this author Lillian Xie More articles by this author Raphael Arada More articles by this author John Sung More articles by this author Francis Jefferson More articles by this author Egor Parkhomenko More articles by this author Daniel Lama More articles by this author Shoaib Safiullah More articles by this author Pengbo Jiang More articles by this author Roshan Patel More articles by this author Ralph Clayman More articles by this author Jaime Landman More articles by this author Expand All Advertisement PDF downloadLoading ...