Abstract：
OBJECTIVE: To report real-time IRP and FR while performing flexible ureteroscopy in porcine kidney model utilizing LithoVue™ Elite (Boston Scientific®) with different irrigation systems, including automated pumps.
METHODS: Using an ex-vivo model of porcine kidney, IRPs were measured with LithoVue Elite. Ureteroscopic settings (US) were tested with all permutations of irrigation methods (IM), working channel occupant (WCO), and ureteral access sheaths (UAS). IMs included: Single Action Pumping System (SAPS™, Boston Scientific), Thermedx FluidSmart™ (Stryker®), and ENDOMAT™ (Karl Storz®). Pumps were tested at 50, 100, and 150 mmHg. WCOs included a 1.9Fr zero-tip basket, 200 µm, and 365 µm laser fibers. UASs utilized 11/13Fr and 12/14Fr 36 cm.
RESULTS: 84 different US were tested (252 experiments). ENDOMAT had higher IRP but the same FR as Thermedx at the same US for 50 and 100 mmHg (p < 0.01). SAPS had higher IRP and FR than pumps in all US studies (p < 0.01). There was positive correlation between pressure set by the pump and both IRP and FR (rho > 0.9). As the diameter of the WCO increased, lower IRP and FR were observed with the pumps (p < 0.01). With SAPS, IRP was similar regardless of WCO, but FR was decreased with the increased diameter of WCO (p = 0.81 and p < 0.01, respectively). There was significantly higher IRP when using 11/13Fr UAS than 12/14Fr (p < 0.01).
CONCLUSIONS: IRP was higher with SAPS than automated pumps. ENDOMAT showed higher IRP than Thermedx when under 150 mmHg. IRP and FR increase with higher pump pressure and decrease with larger diameter WCO. Likewise, a larger UAS significantly reduced IRP.
METHODS: Using an ex-vivo model of porcine kidney, IRPs were measured with LithoVue Elite. Ureteroscopic settings (US) were tested with all permutations of irrigation methods (IM), working channel occupant (WCO), and ureteral access sheaths (UAS). IMs included: Single Action Pumping System (SAPS™, Boston Scientific), Thermedx FluidSmart™ (Stryker®), and ENDOMAT™ (Karl Storz®). Pumps were tested at 50, 100, and 150 mmHg. WCOs included a 1.9Fr zero-tip basket, 200 µm, and 365 µm laser fibers. UASs utilized 11/13Fr and 12/14Fr 36 cm.
RESULTS: 84 different US were tested (252 experiments). ENDOMAT had higher IRP but the same FR as Thermedx at the same US for 50 and 100 mmHg (p < 0.01). SAPS had higher IRP and FR than pumps in all US studies (p < 0.01). There was positive correlation between pressure set by the pump and both IRP and FR (rho > 0.9). As the diameter of the WCO increased, lower IRP and FR were observed with the pumps (p < 0.01). With SAPS, IRP was similar regardless of WCO, but FR was decreased with the increased diameter of WCO (p = 0.81 and p < 0.01, respectively). There was significantly higher IRP when using 11/13Fr UAS than 12/14Fr (p < 0.01).
CONCLUSIONS: IRP was higher with SAPS than automated pumps. ENDOMAT showed higher IRP than Thermedx when under 150 mmHg. IRP and FR increase with higher pump pressure and decrease with larger diameter WCO. Likewise, a larger UAS significantly reduced IRP.
摘要：
目的：使用不同灌溉系统的LithoVue™Elite（波士顿科学®）在猪肾模型中进行输尿管软镜检查时，报告实时IRP和FR，包括自动泵。
方法：使用猪肾的离体模型，IRP用LithoVueElite测量。输尿管镜设置（US）与所有排列的冲洗方法（IM）进行了测试，工作通道占用者(WCO)，和输尿管通道鞘（UAS）。包括IMs:单动泵送系统(SAPS™,波士顿科学公司)，ThermedxFluidSmart™(Stryker®),和ENDOMAT™(KarlStorz®)。在50、100和150mmHg下测试泵。WCO包括1.9Fr零尖端篮，200µm,和365微米激光光纤。UAS使用11/13Fr和12/14Fr36厘米。
结果：测试了84个不同的美国（252个实验）。ENDOMAT具有较高的IRP，但在50和100mmHg的相同US下与Thermedx具有相同的FR（p<0.01）。在所有美国研究中，SAPS的IRP和FR均高于泵（p<0.01）。泵设定的压力与IRP和FR之间存在正相关(rho>0.9)。随着WCO直径的增加，用泵观察到较低的IRP和FR(p<0.01)。有了SAPS,无论世界海关组织如何，IRP都是相似的，但FR随着WCO直径的增加而降低（分别为p=0.81和p<0.01）。使用11/13FrUAS时，IRP明显高于12/14Fr（p<0.01）。
结论：使用SAPS的IRP高于自动泵。在150mmHg以下时，ENDOMAT的IRP高于Thermedx。IRP和FR随着泵压力的增加而增加，随着WCO直径的增加而减小。同样，较大的UAS显着降低了IRP。
方法：使用猪肾的离体模型，IRP用LithoVueElite测量。输尿管镜设置（US）与所有排列的冲洗方法（IM）进行了测试，工作通道占用者(WCO)，和输尿管通道鞘（UAS）。包括IMs:单动泵送系统(SAPS™,波士顿科学公司)，ThermedxFluidSmart™(Stryker®),和ENDOMAT™(KarlStorz®)。在50、100和150mmHg下测试泵。WCO包括1.9Fr零尖端篮，200µm,和365微米激光光纤。UAS使用11/13Fr和12/14Fr36厘米。
结果：测试了84个不同的美国（252个实验）。ENDOMAT具有较高的IRP，但在50和100mmHg的相同US下与Thermedx具有相同的FR（p<0.01）。在所有美国研究中，SAPS的IRP和FR均高于泵（p<0.01）。泵设定的压力与IRP和FR之间存在正相关(rho>0.9)。随着WCO直径的增加，用泵观察到较低的IRP和FR(p<0.01)。有了SAPS,无论世界海关组织如何，IRP都是相似的，但FR随着WCO直径的增加而降低（分别为p=0.81和p<0.01）。使用11/13FrUAS时，IRP明显高于12/14Fr（p<0.01）。
结论：使用SAPS的IRP高于自动泵。在150mmHg以下时，ENDOMAT的IRP高于Thermedx。IRP和FR随着泵压力的增加而增加，随着WCO直径的增加而减小。同样，较大的UAS显着降低了IRP。
