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Single use disposable digital flexible ureteroscopes: an ex-vivo assessment and cost analysis.

Single use disposable digital flexible ureteroscopes: an ex-vivo assessment and cost analysis.
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Hennessey DB, Fojecki G, Papa N, Lawrentschuk N, Bolton D,


Hennessey DB, Fojecki G, Papa N, Lawrentschuk N, Bolton D, (click to view)

Hennessey DB, Fojecki G, Papa N, Lawrentschuk N, Bolton D,

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BJU international 2018 04 15() doi 10.1111/bju.14235
Abstract
OBJECTIVE
The single use flexible ureteroscope (fURS), the LithoVue is an important recent development. We aim to measure the capability of this instrument and to assess if there is a benefit to switching to single use instruments.

PATIENTS AND METHODS
The LithoVue was compared to Olympus URF-V and Stortz Flex Xc ex-vivo. An analysis of reusable fURS usage was performed to evaluate damage, durability and maintenance costs. This was then compared to the projected costs of using single use instruments.

RESULTS
Flexion, deflection and irrigation flow of the LithoVue was equivalent, if not better than reusable instruments. An analysis of 234 procedures with 7 new Olympus URF-V scopes, revealed 15 scope damages. Staghorn stones and lower pole/midzone stones were significant risk factors for damage, p=0.014. Once damage occurred, it was likely to occur again. Total repair costs were $162,628 (£92,411), the mean cost per case is $695 (£395). Factoring in the purchase cost, cleaning and repair costs, and the cumulative cost of 28 reusable fURS cases is approximately $50,000 (£28,412). If the LithoVue was priced at $1200 AUD, switching to a single use scope would cost approximately $35,000 (£19,888).

CONCLUSION
The LithoVue is analogous to reusable fURS scopes in regard to standard technical metrics. Depending on its purchase cost it may also represent a cost saving for hospitals when compared to the cumulative costs of maintaining reusable fURS. Additionally, urologist may consider to use the scope in cases in which reusable scope damage is anticipated. This article is protected by copyright. All rights reserved.

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