Initial Experience and Clinical Assessment of the Karl Storz FLEX-XC1 Single-Use Flexible Ureteroscope

No AccessUrology PracticeNew Technology and Techniques13 Mar 2024Initial Experience and Clinical Assessment of the Karl Storz FLEX-XC1 Single-Use Flexible UreteroscopeThis article is commented on by the following:Editorial Commentary Jamal Alamiri, Robert Qi, Kevin F. Hanna, Lindsay A. White, Garrett N. Ungerer, Jayson P. Kemble, Carly A. Thompson, Aaron M. Potretzke, and Kevin Koo Jamal AlamiriJamal Alamiri Department of Urology, Mayo Clinic, Rochester, Minnesota , Robert QiRobert Qi Department of Urology, Mayo Clinic, Rochester, Minnesota , Kevin F. HannaKevin F. Hanna Department of Urology, Mayo Clinic, Rochester, Minnesota , Lindsay A. WhiteLindsay A. White Department of Urology, Mayo Clinic, Rochester, Minnesota , Garrett N. UngererGarrett N. Ungerer Department of Urology, Mayo Clinic, Rochester, Minnesota , Jayson P. KembleJayson P. Kemble Department of Urology, Mayo Clinic, Rochester, Minnesota , Carly A. ThompsonCarly A. Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota , Aaron M. PotretzkeAaron M. Potretzke Department of Urology, Mayo Clinic, Rochester, Minnesota , and Kevin KooKevin Koo Corresponding Author: Kevin Koo, MD, MPH, Department of Urology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 E-mail Address: [email protected] https://orcid.org/0000-0003-0627-5518 Department of Urology, Mayo Clinic, Rochester, Minnesota View All Author Informationhttps://doi.org/10.1097/UPJ.0000000000000552AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareFacebookLinked InTwitterEmail Abstract Introduction: The Karl Storz FLEX-XC1 is a novel single-use flexible ureteroscope that uses the same videographics platform as its reusable digital counterpart. We evaluated the technical performance of the FLEX-XC1 in its initial clinical use. Methods: We reviewed a series of consecutive ureteroscopy procedures performed by 2 endourologists using the FLEX-XC1 for indications for which we typically use a single-use device: total stone burden >15 mm or >10 mm in the lower pole, anticipated case duration >60 minutes, bilateral procedure, or upper tract urothelial cancer procedures. We assessed device tip deflection, intraoperative mechanical failure, and clinical outcomes for each case. Surgeons rated visual clarity, image quality, and maneuverability on a 1 to 5 Likert scale. Results: Of 29 procedures using FLEX-XC1, 27 (93%) were successfully completed. Preoperative upward deflection was < 270° in 6 (21%) cases, and downward deflection was <270° in 9 (31%) cases. Three types of intraoperative malfunctions occurred: rotational twisting of deflectable tip (4 cases, 13%), device not advancing through distal ureter (1 case, 3%), and working channel not accommodating a 365-μm laser (1 case, 3%). Visual clarity, image quality, and maneuverability were rated as 5 "very good" or 4 "good" in 100%, 100%, and 97% of cases, respectively. No device-specific or general 30-day complications were observed. Conclusions: The FLEX-XC1 showed comparable image quality and maneuverability to reusable digital devices. We observed incomplete deflection in up to 31% of cases and mechanical failure in 2 cases. The FLEX-XC1 may be advantageous in prolonged cases where maintaining visual clarity is paramount. References 1. . Is there a difference in outcomes between digital and fiberoptic flexible ureterorenoscopy procedures?. J Endourol.2010; 24(12):1929-1934. Crossref, Medline, Google Scholar 2. . Conventional fiberoptic flexible ureteroscope versus fourth generation digital flexible ureteroscope: a critical comparison. J Endourol.2010; 24(1):17-21. Crossref, Medline, Google Scholar 3. . Understanding the costs of flexible ureteroscopy. Minerva Urol Nefrol.2016; 68(6):586-591. 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Environmental impact of single-use and reusable flexible cystoscopes. BJU Int.2023; 131(5):617-622. Crossref, Medline, Google Scholar 21. . Carbon footprint in flexible ureteroscopy: a comparative study on the environmental impact of reusable and single-use ureteroscopes. J Endourol.2018; 32(3):214-217. Crossref, Medline, Google Scholar Recusal: Dr Koo is a member of the Urology Practice® editorial committee and an AUA publications online content editor and was recused from the editorial and peer review processes. Funding/Support: None. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. 22-013172). Author Contributions: Conception and design: Potretzke, Thompson, Alamiri, Koo. Data analysis and interpretation: Potretzke, Ungerer, Alamiri, Kemble, Hanna, White, Qi. Drafting the manuscript: Alamiri, Kemble, Koo, Qi. Critical revision of the manuscript for scientific and factual content: Potretzke, Thompson, Ungerer, Alamiri, Hanna, Koo, White, Qi. Statistical analysis: Ungerer, Alamiri, Kemble. Supervision: Potretzke, Thompson, Hanna, Koo, White, Qi. Data Availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsRelated articlesUrology Practice28 Feb 2024Editorial Commentary Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.KeywordsFLEX-XC1single-use ureteroscopeureteroscopytechnologyurolithiasisMetrics Author Information Jamal Alamiri Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Robert Qi Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Kevin F. Hanna Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Lindsay A. White Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Garrett N. Ungerer Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Jayson P. Kemble Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Carly A. Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Aaron M. Potretzke Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Kevin Koo Department of Urology, Mayo Clinic, Rochester, Minnesota Corresponding Author: Kevin Koo, MD, MPH, Department of Urology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 E-mail Address: [email protected] More articles by this author Expand All Recusal: Dr Koo is a member of the Urology Practice® editorial committee and an AUA publications online content editor and was recused from the editorial and peer review processes. Funding/Support: None. Conflict of Interest Disclosures: The Authors have no conflicts of interest to disclose. Ethics Statement: This study received Institutional Review Board approval (IRB No. 22-013172). Author Contributions: Conception and design: Potretzke, Thompson, Alamiri, Koo. Data analysis and interpretation: Potretzke, Ungerer, Alamiri, Kemble, Hanna, White, Qi. Drafting the manuscript: Alamiri, Kemble, Koo, Qi. Critical revision of the manuscript for scientific and factual content: Potretzke, Thompson, Ungerer, Alamiri, Hanna, Koo, White, Qi. Statistical analysis: Ungerer, Alamiri, Kemble. Supervision: Potretzke, Thompson, Hanna, Koo, White, Qi. Data Availability: The datasets generated and/or analyzed during the current study are available from the corresponding author on reasonable request. Advertisement PDF downloadLoading ...