Operator-assisted vs self-achieved basketing during ureteroscopy: results from an in vitro preference study.

Autor: Ventimiglia E; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.; Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy., Sindhubodee S; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.; Division of Urology, Department of Surgery, Rajavithi Hospital, Bangkok, Thailand., Besombes T; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France., Pauchard F; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France.; Department of Urology, Hospital Carlos Van Buren, Valparaiso, Chile., Quadrini F; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France., Delbarre B; Centre Hospitalier Universitaire Angers, Angers, France., Jiménez Godínez A; Department of Surgery, University of Guadalajara, Guadalajara, Jalisco, Mexico., Barghouthy Y; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France., Corrales Acosta MA; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France., Kamkoum H; Urology Department, Hazm Mebaireek General Hospital (HMGH), Doha, Qatar., Villa L; Division of Experimental Oncology/Unit of Urology, URI-Urological Research Institute, IRCCS Ospedale San Raffaele, 20132, Milan, Italy., Doizi S; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France., Somani BK; University Hospital Southampton NHS Trust, Southampton, UK., Traxer O; GRC n°20, Groupe de Recherche Clinique sur la Lithiase Urinaire, Hôpital Tenon, Sorbonne Université, 75020, Paris, France. olivier.traxer@aphp.fr.; Service d'Urologie, Assistance-Publique Hôpitaux de Paris, Hôpital Tenon, Sorbonne Université, 4 rue de la Chine, 75020, Paris, France. olivier.traxer@aphp.fr.
Jazyk: angličtina
Zdroj: World journal of urology [World J Urol] 2021 Jun; Vol. 39 (6), pp. 2169-2175. Date of Electronic Publication: 2020 Oct 06.
DOI: 10.1007/s00345-020-03431-5
Abstrakt: Objectives: A recently introduced device (LithoVue Empower™ or LE, Boston Scientifics, USA) allows the surgeon to directly control the stone-retrieving basket without the need of an assistant during flexible ureteroscopy. We aimed to evaluate the stone-retrieval performance of this device.
Methods: We used a bench-training model for flexible ureteroscopy, the Key-box (K-Box®, Porgès-Coloplast, France), to compare the LE configured with a 1.9F stone-retrieval tipless basket (ZeroTip™, Boston Scientific, USA) and a traditional assistant-maneuvered 1.9F stone-retrieval tipless basket. Seven experienced endo-urologists and seven residents-in-training retrieved a fake stone from three different renal cavities of the K-Box with increasing access complexity first with the traditional basket and then with the LE device. We recorded retrieval time and all the operators filled in the NASA Task Load Index (TLI) for the self-evaluation of their performance. We then compared the use of LE in terms of retrieval time, failure rates, and NASA-TLI scores.
Results: Stone retrieval times and failure rates were similar according to the retrieval technique, although residents had non-statistically significant shorter times with the LE. NASA-TLI scores revealed lower frustration (p = 0.03) when LE was used by experienced urologists as compared to the traditional basketing. When stratifying the analyses according to surgical experience, fully trained urologists performed faster stone retrieval and showed lower effort scores than residents-in-training (p < 0.05).
Conclusions: The individually controlled retrieval system is an effective device assisting stone retrieval and does not necessitate specific training among experienced endo-urologists. Young residents might benefit from LE during their learning curve.
Databáze: MEDLINE
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