World journal of urology · 2025
Automated intrarenal pressure control in flexible ureteroscopy using an integrated ureteroscope pressure measurement and fluid management system: first-in-human use.
СтатьяНаблюдательное исследованиеМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Fulla Juan, Larenas Francisca, Saldivia Diego, Ibañez Helga, Elorrieta Vicente, Sanchez Catherine, Salvadó José A
Аннотация
PURPOSE: To evaluate the safety and clinical performance of a fluid-management system with intrarenal pressure management during flexible ureteroscopy in patients with renal or ureteral stones.
METHODS: prospective, observational, descriptive study at two centers in Santiago, Chile, from April to June 2025. Adults (≥ 18 years) with confirmed upper urinary tract stones undergoing flexible ureteroscopy were included (n = 14). Exclusion criteria comprised active urinary infection, significant anatomical abnormalities, pregnancy or lactation. All procedures employed a single-use LithoVue Elite ureteroscope integrated with Asurys. Continuous intrarenal pressure measurements were recorded, with the Asurys system configured in LithoVue Elite Mode using a target pressure limit of 25-35 cmH₂O (18.4-25.8 mmHg) (flow limiter) and adjustable flush limiter (typically 80-100 cmH₂O (58.8-73.6 mmHg)). Intraoperative parameters, including operative time, laser usage, and instrument sheath utilization, were documented. Postoperative complications were classified by Clavien-Dindo. Laboratory values (e.g., C-reactive protein, fibrinogen, creatinine) were obtained preoperatively and 2-3 h postoperatively.
RESULTS: The mean age was 51 years, 78% were male. Stones had a median diameter of 8 mm and a median volume of 189.9 mm³. Median operative time was 60 min (range 50.0-90.5). The mean intrarenal pressure was 29 ± 13 cmH₂O (21.3 ± 9.6 mmHg). One patient (7%) experienced a Clavien-Dindo II urinary tract infection; one (7%) had grade I pain.
CONCLUSION: Asurys was associated with low complication rates and high surgeon satisfaction, suggesting that automated pressure control is safe and effective during flexible ureteroscopy.
METHODS: prospective, observational, descriptive study at two centers in Santiago, Chile, from April to June 2025. Adults (≥ 18 years) with confirmed upper urinary tract stones undergoing flexible ureteroscopy were included (n = 14). Exclusion criteria comprised active urinary infection, significant anatomical abnormalities, pregnancy or lactation. All procedures employed a single-use LithoVue Elite ureteroscope integrated with Asurys. Continuous intrarenal pressure measurements were recorded, with the Asurys system configured in LithoVue Elite Mode using a target pressure limit of 25-35 cmH₂O (18.4-25.8 mmHg) (flow limiter) and adjustable flush limiter (typically 80-100 cmH₂O (58.8-73.6 mmHg)). Intraoperative parameters, including operative time, laser usage, and instrument sheath utilization, were documented. Postoperative complications were classified by Clavien-Dindo. Laboratory values (e.g., C-reactive protein, fibrinogen, creatinine) were obtained preoperatively and 2-3 h postoperatively.
RESULTS: The mean age was 51 years, 78% were male. Stones had a median diameter of 8 mm and a median volume of 189.9 mm³. Median operative time was 60 min (range 50.0-90.5). The mean intrarenal pressure was 29 ± 13 cmH₂O (21.3 ± 9.6 mmHg). One patient (7%) experienced a Clavien-Dindo II urinary tract infection; one (7%) had grade I pain.
CONCLUSION: Asurys was associated with low complication rates and high surgeon satisfaction, suggesting that automated pressure control is safe and effective during flexible ureteroscopy.