ABSTRACT
Objective
To compare the maintenance costs of digital flexible ureteroscopes (DFU) versus fiberoptic
flexible ureteroscopes (FFU) to understand the long-term financial impact associated
with breakage in a flexible ureteroscopy (f-URS) program.
Methods
Data for breakage of FFU and DFU at an academic institution from 2019 to 2021 were
obtained from our vendor (Karl Storz) and analyzed by month. Correlation test was
used to evaluate significant differences in number of procedures, number of breakage
events, breakage rates, and repair cost per month. Cumulative analyses were utilized
to examine the number of procedures before failure (time to failure - TTF) and repair
costs per procedure (RCpP).
Results
We performed a total of 2,154 f-URS, including 1,355 with FFU and 799 with DFU (P<.001). Although we found a higher number of breakage events in FFU (n=124) than DFU
(n=73) (P<.001), the overall breakage rate was similar, 9.9% vs. 8.8%, respectively (P=0.86). On cumulative analysis, both modalities reached the same TTF plateau (11 cases)
after 18 months. After 400 cases, the RCpP for DFU was 1.25 times higher than for
FFU (P=0.04).
Conclusion
Overall, we found no difference in overall scope breakage rates between DFU and FFU.
Although there was no difference in TTF over time, at the beginning DFU displayed
considerable higher durability, leading to lower RCpP. Furthermore, DFU's endurance
leveled off to FFU over time, resulting in higher RCpP after 400 cases. This finding
may be explained by the presence of renewed scopes after repair.
Abbreviations:
DFU (digital flexible ureteroscope), f-URS (flexible ureteroscopy), FFU (fiberoptic flexible ureteroscope), PGY (post-graduate year), RCpP (repair cost per procedure), suFU (single-use flexible ureteroscope), TCpP (total cost per procedure), TTF (time to failure)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: November 15, 2022
Accepted:
October 30,
2022
Received:
July 13,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
