A Prospective Case-Control Study Comparing LithoVue, a Single-Use, Flexible Disposable Ureteroscope, with Flexible, Reusable Fiber-Optic Ureteroscopes

Abstract

Objective: LithoVue™ is a novel, single-use, digital flexible ureteroscope that was released to the US market in January 2016. There are scant data regarding its performance in humans. Procedural outcomes comparing LithoVue with reusable ureteroscopes are presented in patients undergoing ureteroscopy for upper urinary tract pathology.

Patients and methods: Clinical outcomes between two groups of patients undergoing flexible ureteroscopy for upper urinary tract pathology were analyzed. The first group underwent surgery utilizing LithoVue, and the second group used reusable fiber-optic flexible ureteroscopes. Differences in procedural outcomes, operative times, and time spent in hospital were analyzed using two-tailed t-tests and chi-squared and Fisher's exact tests.

Results: One hundred fifteen cases utilizing LithoVue and 65 cases utilizing reusable ureteroscopes were included in this study. Demographics, surgical indications, stone size, location, total stone burden, composition, procedural outcomes, and complications were comparable between groups. For all cases, LithoVue procedures lasted 54.1 ± 25.7 minutes compared with 64.5 ± 37.0 minutes for reusable scope procedures (p < 0.05) and for stone removal cases, 57.3 ± 25.1 vs 70.3 ± 36.9 minutes, respectively (p < 0.05). Scope failure occurred in 4.4% of LithoVue cases and 7.7% of reusable cases (p = 0.27).

Conclusions: LithoVue represents a feasible alternative to reusable ureteroscopes with a low rate of scope failure comparable with reusable ureteroscopes. Its use shortens procedure duration, a finding that warrants further investigation.

Keywords: equipment design; kidney calculi; ureteroscopes; urolithiasis.

Conflict of interest statement

No competing financial interests exist.

Figures

FIG. 1.

Impact of LithoVue™ use on procedure duration and hospital stay. (A) Mean procedure duration decreased from 64.5 ± 37.0 to 54.1 ± 25.7 minutes (p < 0.05) for all procedures (left panel) and from 70.3 ± 36.9 to 57.3 ± 25.1 minutes (p < 0.05) for stone removal procedures (right panel) with the use of LithoVue. (B) Mean operating room duration decreased from 100.0 ± 38.8 to 86.7 ± 28.2 minutes (p < 0.05) for all procedures (left panel) and from 104.3 ± 39.4 to 89.8 ± 27.8 minutes (p < 0.05) for stone removal procedures (right panel) with the use of LithoVue. (C) Mean hospital stay changed from 503.6 ± 879.7 to 309.8 ± 673.2 minutes (p = 0.34) for all procedures (left panel) and from 564.7 ± 981.1 to 414.9 ± 727.8 minutes (p = 0.31) for stone removal procedures (right panel) with the use of LithoVue, differences that were not statistically significantly different. Comparisons between reusable flexible ureteroscope and LithoVue outcomes were performed using unpaired Student's t-test. Data shown are mean ± standard deviation.