Flexible ureteroscopy with integrated suction, a useful innovation: a systematic review by the YAU and EAU endourology sections.
Theodoros Spinos, Lucasz Nowak, Bhaskar K Somani et al.
✦ AI-curated · Sources linked
In 30 seconds
This systematic review assessed direct in-scope suction (DISS) during retrograde intrarenal surgery for renal and ureteral stones, drawing on clinical and experimental studies. Eighteen studies met the inclusion criteria; seven were in vitro and two ex vivo. Reported stone-free rates ranged from 39.5% to 100%, and auxiliary procedure rates from 0% to 33.3%. The authors concluded that DISS was feasible, safe and efficient, with reported uses including fragment evacuation, stone relocation and reduction of intrarenal pressure.
Key findings
- Across the included studies, stone-free rates ranged from 39.5% to 100%.
- Auxiliary procedure rates ranged from 0% to 33.3%.
- Intraoperative complication rates ranged from 0% to 58.6%; Grade III-IV complications ranged from 0% to 4.5%.
- DISS was reported for dust or residual-fragment evacuation, stone relocation and intrarenal pressure reduction.
Why it matters
DISS may offer a way to manage fragments and intrarenal pressure during ureteroscopy, while also supporting stone relocation. The wide ranges in stone-free and complication rates show that outcomes varied across the evidence base, so the review is informative about potential applications but does not establish a uniform benefit.
What to keep in mind
The review included a mix of clinical and experimental studies, including in vitro and ex vivo work; reported outcome ranges were wide.