Flexible Ureteroscopy: Technique, Tips and Tricks

Overview

Journal Urolithiasis

Publisher Springer

Specialty Urology

Date 2017 Dec 10

PMID 29222575

Citations 45

Authors

Steeve Doizi

Olivier Traxer

Affiliations

Soon will be listed here.

Abstract

During the last decades, the surgical management of kidney stones benefited of many technological advances and one of them is the development of flexible ureteroscopy (fURS). This tool, ancillary equipment such as graspers and baskets, and lithotripsy technique with Holmium:YAG laser underwent many improvements leading to a widening of its indications with diagnostic and therapeutic management of upper urinary tract pathologies such as urolithiasis and urothelial tumors. The objective of this review is to describe the surgical technique for fURS as well as tips and tricks for the treatment of renal stones.

Citing Articles

Advances in the mechanism of urinary proteins in calcium oxalate kidney stone formation.

Shi M, Su X, Xiang H, Song Q, Yang S Urolithiasis. 2025; 53(1):27.

PMID: 39932538 DOI: 10.1007/s00240-025-01703-6.

RIRS with FV-UAS vs. ESWL for the management of 1-2 cm lower pole renal calculi in obese patients: a prospective study.

Men C, Xu M, Zhang S, Wang Q, Wu J, Li Y Front Med (Lausanne). 2024; 11:1464491.

PMID: 39540048 PMC: 11557427. DOI: 10.3389/fmed.2024.1464491.

The efficacy and safety of three different single-use ureteroscopes in retrograde intrarenal surgery: a comparative analysis of a single surgeon's experience in a single center.

Sahin M, Topkac E, Seramet S, Dogan C, Yazici C World J Urol. 2024; 42(1):583.

PMID: 39422797 DOI: 10.1007/s00345-024-05283-9.

Renal artery pseudoaneurysm presenting in a single functioning kidney with prior partial nephrectomy following flexible ureterorenoscopy: a case report.

Asi T, Khamashta N, Dalal A J Surg Case Rep. 2024; 2024(9):rjae594.

PMID: 39291252 PMC: 11407829. DOI: 10.1093/jscr/rjae594.

Exploring the Impact of Gender-Specific Approaches inRetrograde Intrarenal Surgery: Effects on Operative Efficiency and Patient Recovery.

Hilowle A, Mohamed A Res Rep Urol. 2024; 16:177-185.

PMID: 39229592 PMC: 11370754. DOI: 10.2147/RRU.S480374.

References

Patel S, McLaren I, Nakada S . The ureteroscope as a safety wire for ureteronephroscopy. J Endourol. 2011; 26(4):351-4. DOI: 10.1089/end.2011.0406. View

Assimos D, Krambeck A, Miller N, Monga M, Murad M, Nelson C . Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART I. J Urol. 2016; 196(4):1153-60. DOI: 10.1016/j.juro.2016.05.090. View

Sener T, Cloutier J, Villa L, Marson F, Buttice S, Doizi S . Can We Provide Low Intrarenal Pressures with Good Irrigation Flow by Decreasing the Size of Ureteral Access Sheaths?. J Endourol. 2015; 30(1):49-55. DOI: 10.1089/end.2015.0387. View

Doizi S, Kamphuis G, Giusti G, Andreassen K, Knoll T, Osther P . First clinical evaluation of a new single-use flexible ureteroscope (LithoVue™): a European prospective multicentric feasibility study. World J Urol. 2016; 35(5):809-818. DOI: 10.1007/s00345-016-1936-x. View

Bach T, Geavlete B, Herrmann T, Gross A . Working tools in flexible ureterorenoscopy--influence on flow and deflection: what does matter?. J Endourol. 2008; 22(8):1639-43. DOI: 10.1089/end.2008.0184. View

Kronenberg P, Traxer O . Lithotripsy Performance of Specially Designed Laser Fiber Tips. J Urol. 2015; 195(5):1606-1612. DOI: 10.1016/j.juro.2015.10.135. View

Auge B, Pietrow P, Lallas C, Raj G, Santa-Cruz R, Preminger G . Ureteral access sheath provides protection against elevated renal pressures during routine flexible ureteroscopic stone manipulation. J Endourol. 2004; 18(1):33-6. DOI: 10.1089/089277904322836631. View

Giusti G, Proietti S, Villa L, Cloutier J, Rosso M, Gadda G . Current Standard Technique for Modern Flexible Ureteroscopy: Tips and Tricks. Eur Urol. 2016; 70(1):188-194. DOI: 10.1016/j.eururo.2016.03.035. View

Song T, Liao B, Zheng S, Wei Q . Meta-analysis of postoperatively stenting or not in patients underwent ureteroscopic lithotripsy. Urol Res. 2011; 40(1):67-77. DOI: 10.1007/s00240-011-0385-7. View

10.

Shin R, Lautz J, Cabrera F, Shami C, Goldsmith Z, Kuntz N . Evaluation of Novel Ball-Tip Holmium Laser Fiber: Impact on Ureteroscope Performance and Fragmentation Efficiency. J Endourol. 2015; 30(2):189-94. DOI: 10.1089/end.2015.0300. View

11.

Assimos D, Krambeck A, Miller N, Monga M, Murad M, Nelson C . Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol. 2016; 196(4):1161-9. DOI: 10.1016/j.juro.2016.05.091. View

12.

Rassweiler J, Klein J . Re: Update on Lasers in Urology. Current Assessment on Holmium:yttrium-aluminum-garnet (Ho:YAG) Laser Lithotripter Settings and Laser Fibers. Eur Urol. 2016; 70(3):538-9. DOI: 10.1016/j.eururo.2016.06.026. View

13.

Netto Junior N, Claro J, Esteves S, Andrade E . Ureteroscopic stone removal in the distal ureter. Why change?. J Urol. 1997; 157(6):2081-3. DOI: 10.1097/00005392-199706000-00012. View

14.

Doizi S, Knoll T, Scoffone C, Breda A, Brehmer M, Liatsikos E . First clinical evaluation of a new innovative ureteral access sheath (Re-Trace™): a European study. World J Urol. 2013; 32(1):143-7. DOI: 10.1007/s00345-013-1094-3. View

15.

Proietti S, Dragos L, Molina W, Doizi S, Giusti G, Traxer O . Comparison of New Single-Use Digital Flexible Ureteroscope Versus Nondisposable Fiber Optic and Digital Ureteroscope in a Cadaveric Model. J Endourol. 2016; 30(6):655-9. PMC: 4913498. DOI: 10.1089/end.2016.0051. View

16.

de la Rosette J, Denstedt J, Geavlete P, Keeley F, Matsuda T, Pearle M . The clinical research office of the endourological society ureteroscopy global study: indications, complications, and outcomes in 11,885 patients. J Endourol. 2013; 28(2):131-9. DOI: 10.1089/end.2013.0436. View

17.

Chawla S, Chang M, Chang A, LeNoir J, Bagley D . Effectiveness of high-frequency holmium:YAG laser stone fragmentation: the "popcorn effect". J Endourol. 2008; 22(4):645-50. DOI: 10.1089/end.2007.9843. View

18.

Kronenberg P, Traxer O . Update on lasers in urology 2014: current assessment on holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripter settings and laser fibers. World J Urol. 2014; 33(4):463-9. DOI: 10.1007/s00345-014-1395-1. View

19.

Netto Jr N, Ikonomidis J, Zillo C . Routine ureteral stenting after ureteroscopy for ureteral lithiasis: is it really necessary?. J Urol. 2001; 166(4):1252-4. View

20.

Keeley Jr F, Timoney A . Routine stenting after ureteroscopy: think again. Eur Urol. 2007; 52(3):642-4. DOI: 10.1016/j.eururo.2007.01.087. View