Digital Ureteroscopy: The Next Step

Abstract

Introduction:

Flexible ureteroscopy is a powerful endourologic procedure for diagnosing and treating upper urinary tract disease such as stone disease, transitional cell carcinoma, and ureteral strictures. Despite technological advances in making flexible ureteroscopes with smaller caliber, the fiberoptic scope usually suffers from a grainy image. Further, the fiberoptic ureteroscopes are fragile, requiring costly repairs. Therefore, new technology to overcome these deficiencies in current endoscopes is needed.

Methods:

The new Invisio DUR-D digital flexible ureteroscope from Gyrus ACMI (Southborough, MA) was tested for the first time.

Results:

The tip of this scope houses dual light emitting diode–driven light carriers and a 1-mm digital camera, which obviates an external xenon light source and eliminates the need for a hot light cord to light source, thus eliminating the risk of drape fires and patient burns. Since there are no external cameras or light cables, the DUR-D digital ureteroscope is much lighter and more ergonomic than the fiberoptic ureteroscope. There is no need to focus or white balance—just plug and play. The weight of the DUR-D is 505 g, whereas the fiberoptic DUR-8 Elite ureteroscope with external camera and light cord can weigh up to 1012 g. This represents a 50% reduction in weight. The tip of the Invisio DUR-D digital flexible ureteroscope is 8.7F with a 3.6F working channel and is capable of dual 250 degrees of articulation. The 1-mm digital camera at the tip eliminates the need for fragile low-resolution fiberoptics and provides unprecedented resolution. Further, the laser fiber detection system recognizes and deactivates the laser whenever the fiber is retracted within the ureteroscope to prevent accidental misfiring of the laser, thus reducing laser-caused scope damage, and helps prolong the life of the instrument.

Conclusions:

The latest generation of digital ureteroscopes provides better image resolution and quality. They also reduce the risk of fires associated with external xenon light sources. Long-term use of this digital ureteroscope is needed to compare its durability with the traditional fiberoptic ureteroscopes.

No competing financial interests exist.

Runtime of video: 6 min 28 sec