Comparison of automated irrigation systems using an in vitro ureteroscopy model.
Research
Technology
Ureteroscopy
Journal
International braz j urol : official journal of the Brazilian Society of Urology
ISSN: 1677-6119
Titre abrégé: Int Braz J Urol
Pays: Brazil
ID NLM: 101158091
Informations de publication
Date de publication:
Historique:
received:
08
04
2019
accepted:
30
08
2019
entrez:
14
3
2020
pubmed:
14
3
2020
medline:
29
8
2020
Statut:
ppublish
Résumé
Two automated irrigation systems have been released for use during endoscopic procedures such as ureteroscopy: the Cogentix RocaFlow® (CRF) and Thermedx FluidSmart® (TFS). Accurate pressure control using automated systems may help providers maintain irrigation pressures within a safe range while also providing clear visualization. Our objective was to directly compare these systems based on their pressure accuracy, pressure-flow relationships, and fluid heating capabilities in order to help providers better utilize the temperature and pressure settings of each system. An in vitro ureteroscopy model was used for testing, consisting of a short semirigid ureteroscope (6/7, 5F, 31cm Wolf 425612) connected to a continuous digital pressure transducer (Meriam m1550). Each system pressure output and flow-rate, via 100mL beaker filling time, was measured using multiple trials at pressure settings between 30 and 300mmHg. Output fluid temperature was monitored using a digital thermometer (Omega DP25-TH). The pressure output of both systems exceeded the desired setting across the entire tested range, a difference of 15.7±2.4mmHg for the TFS compared to 5.2±1.5mmHg for the CRF (p < 0.0001). Related to this finding, the TFS also had slightly higher flow rates across all trials (7±2mL/min). Temperature testing revealed a similar maximum temperature of 34.0⁰C with both systems, however, the TFS peaked after only 8 minutes and started to plateau as early as 4-5 minutes into the test, while the CRF took over 18 minutes to reach a similar peak. Our in vitro ureteroscopy testing found that the CRF system had better pressure accuracy than the TFS system but with noticeably slower fluid heating capabilities. Each system provided steady irrigation at safe pressures within their expected operating parameters with small differences in performance that should not limit their ability to provide steady irrigation at safe pressures.
Identifiants
pubmed: 32167702
doi: 10.1590/S1677-5538.IBJU.2019.0230
pii: IBJU20190230
pmc: PMC7088507
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
390-397Commentaires et corrections
Type : CommentIn
Informations de copyright
Copyright® by the International Brazilian Journal of Urology.
Déclaration de conflit d'intérêts
None declared.
Références
J Endourol. 2003 Mar;17(2):97-101
pubmed: 12689403
J Urol. 2015 Mar;193(3):898
pubmed: 25765396
J Endourol. 2002 May;16(4):221-4
pubmed: 12042103
J Endourol. 2014 May;28(5):549-53
pubmed: 24341909
J Endourol. 2008 Mar;22(3):453-8
pubmed: 18355140
J Endourol. 2018 Jan;32(1):59-63
pubmed: 29048226
Best Pract Res Clin Anaesthesiol. 2008 Dec;22(4):645-57
pubmed: 19137808
J Endourol. 2005 Jun;19(5):562-5
pubmed: 15989446
J Anesth. 2015 Apr;29(2):165-9
pubmed: 25033745
J Endourol. 2004 Oct;18(8):739-42
pubmed: 15659894