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Medairos R, Soto-Palou F, Barquin DL, Margolin EJ, Locascio R, Antonelli J, Preminger G, Lipkin M. The Impact of Single-Use Cystoscopes on Clinical Time Workflow in an Outpatient Setting. Urology 2024; 188:7-10. [PMID: 38653386 DOI: 10.1016/j.urology.2024.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/26/2024] [Accepted: 03/26/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE To evaluate the change in overall clinical encounter time and clinical capacity after transitioning to single-use cystoscopes (Ambu A/S, Ballerup, Denmark) in an outpatient urology setting. METHODS A single-institution prospective study in an outpatient urology procedure clinic was performed. Discrete categories for each portion of nursing care responsibilities were defined, and time spent during each category was recorded. Two separate clinic days were observed and analyzed: one where the clinic exclusively used reusable cystoscopes and the other after the transition to single-use cystoscopes occurred. Additionally, clinic schedules were reviewed from all procedure clinics in the 3-month periods before and after the transition to single-use cystoscopes. Outcomes included overall clinical encounter time and the number of procedures per clinic day. RESULTS There were 12 flexible cystoscopies performed during each of the observed clinic days. Preliminary cystoscope cleaning and transportation tasks by nursing staff were eliminated when utilizing single-use cystoscopes. Average total encounter time decreased from 66 to 44 minutes, resulting in a 34% reduction in clinical encounter time. The median number of flexible cystoscopy procedures increased after the transition from 9 (IQR 7-12) to 16 (IQR 11-17), representing a 78% increase (P = .003). CONCLUSION Transition to a completely single-use cystoscopy outpatient procedure clinic improved clinical efficiency and facilitated an increased number of procedures per clinic day.
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Affiliation(s)
- Robert Medairos
- Department of Urology, Duke University Medical Center, Durham, NC
| | | | - David L Barquin
- Department of Urology, Duke University Medical Center, Durham, NC.
| | - Ezra J Margolin
- Department of Urology, Duke University Medical Center, Durham, NC
| | - Rachel Locascio
- Department of Urology, Duke University Medical Center, Durham, NC
| | - Jodi Antonelli
- Department of Urology, Duke University Medical Center, Durham, NC
| | - Glenn Preminger
- Department of Urology, Duke University Medical Center, Durham, NC
| | - Michael Lipkin
- Department of Urology, Duke University Medical Center, Durham, NC
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Jia K, Luo B, Zhong S, Di W. Reconsideration of surgical treatment plan for pelvic lipomatosis combined with urothelial carcinoma of bladder. Asian J Surg 2024:S1015-9584(24)00711-5. [PMID: 38714415 DOI: 10.1016/j.asjsur.2024.04.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 04/12/2024] [Indexed: 05/09/2024] Open
Affiliation(s)
- Keyang Jia
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China
| | - Bohan Luo
- School of Medicine, University of Electronic Science and Technology of China, Chengdu, 611731, China; Organ Transplantation Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
| | - Shan Zhong
- Organ Transplantation Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China
| | - Wenjia Di
- Organ Transplantation Center, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, 610072, Sichuan, China.
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Haislip I, Rindorf D, Cool C, Tester B. Workflow efficiencies for flexible cystoscopy: comparing single-use vs reusable cystoscopes. BMC Urol 2024; 24:53. [PMID: 38448827 PMCID: PMC10918871 DOI: 10.1186/s12894-024-01436-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 02/20/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Flexible cystoscopy is a common procedure to diagnose and treat lower urinary tract conditions. Single-use cystoscopes have been introduced to eliminate time-consuming reprocessing and costly repairs. We compared the hands-on labor time differences between flexible reusable cystoscopes versus Ambu's aScope™ 4 Cysto (aS4C) at a large urology Ambulatory Surgery Center (ASC). METHODS Reusable and single-use cystoscopy procedures were shadowed for timestamp collection for setup and breakdown. A subset of reusable cystoscopes were followed through the reprocessing cycle. T-tests were calculated to measure the significance between groups. RESULTS The average hands-on time necessary for reusable cystoscope preparation, breakdown, and pre-cleaning was 4'53″. Of this, 2'53″ were required for preparation, while 2'0″ were required for breakdown and pre-cleaning. The average hands-on time for reprocessing for reusable was 7'1" per cycle. The total time for single-use scopes was 2'22″. Of this, 1'36″ was needed for single-use preparation, and 45 s for breakdown. Compared to reusable cystoscopes, single-use cystoscopes significantly reduced pre and post-procedure hands-on labor time by 2'31", or 48%. When including reprocessing, total hands-on time was 80% greater for reusable than single-use cystoscopes. CONCLUSION Single-use cystoscopes significantly reduced hands-on labor time compared to reusable cystoscopes. On average, the facility saw a reduction of 2'31″ per cystoscope for each procedure. This translates to 20 additional minutes gained per day, based on an 8 procedures per day. Utilizing single-use cystoscopes enabled the facility to reduce patient wait times, decrease turnaround times, and free up staff time.
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Affiliation(s)
- Ian Haislip
- Ambu USA, Health Economist, 6271 Columbia Gateway Drive, Suite 200, Columbia, MD, 21046, USA.
| | | | - Christina Cool
- Ambu USA, Health Economist, 6271 Columbia Gateway Drive, Suite 200, Columbia, MD, 21046, USA
- Ambu USA, Columbia, MD, USA
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Chen R, Baas C, Farkouh A, Shete K, Peverini DR, Hartman JC, Amasyali AS, Belle J, Baldwin EA, Baldwin DD. Time Efficiency and Performance of Single-Use vs Reusable Cystoscopes: A Randomized Benchtop and Simulated Clinical Assessment. J Endourol 2024; 38:53-59. [PMID: 37800857 DOI: 10.1089/end.2023.0372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Introduction: A flexible cystoscope is an indispensable tool for urologists, facilitating a variety of procedures in both the operating room and at bedside. Single-use cystoscopes offer benefits including accessibility and decreased burden for reprocessing. The aims of this study were to compare time efficiency and performance of single-use and reusable cystoscopes. Methods: Ten new Ambu® aScope™ 4 Cysto single-use and two Olympus CYF-5 reusable cystoscopes were compared in simulated bedside cystoscopy and benchtop testing. Ten urologists performed simulated cystoscopy using both cystoscopes in a randomized order. Times for supply-gathering, setup, cystoscopy, cleanup, and cumulative time were recorded, followed by a Likert feedback survey. For benchtop assessment, physical, optical, and functional specifications were assessed and compared between cystoscopes. Results: The single-use cystoscope demonstrated shorter supply-gathering, setup, cleanup, and cumulative times (824 vs 1231 seconds; p < 0.05) but a comparable cystoscopy time to the reusable cystoscope (202 vs 212 seconds; p = 0.32). The single-use cystoscope had a higher image resolution, but a narrower field of view. Upward deflection was greater for the single-use cystoscope (214.50° vs 199.45°; p < 0.01) but required greater force (2.5 × ). The working channel diameter and irrigation rate were greater in the reusable cystoscope. While the single-use cystoscope lacked tumor enhancing optical features, it had higher Likert scale scores for Time Efficiency and Overall Satisfaction. Conclusion: The single-use cystoscope demonstrates comparable benchtop performance and superior time efficiency compared to reusable cystoscopes. However, the reusable cystoscope has superior optical versatility and flow rate. Knowledge of these differences allows for optimal cystoscope selection based on procedure indication.
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Affiliation(s)
- Ricky Chen
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Catalina Baas
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Ala'a Farkouh
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Kanha Shete
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Daniel R Peverini
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - John C Hartman
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Akin S Amasyali
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Joshua Belle
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - Elizabeth A Baldwin
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
| | - D Duane Baldwin
- Department of Urology, Loma Linda University Health, Loma Linda, California, USA
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Henderickx MMEL, Hendriks N, Baard J, Beerlage HP, Boom DT, Bosschieter J, Bouma-Houwert AC, Legemate JD, Nieuwenhuijzen JA, Postema AW, Rongen LH, Ronkes BL, Scheltema MJV, van der Sluis TM, Wagstaff PGK, Kamphuis GM. Is It the Load That Breaks You or the Way You Carry It: How Demanding Is Endourology? J Endourol 2023; 37:718-728. [PMID: 37029790 DOI: 10.1089/end.2022.0817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/09/2023] Open
Abstract
Objective: Surgical outcomes are dependent on multiple factors. Besides patient-related or procedure-related factors, several surgeon-related factors contribute to surgical outcomes. The Surgery Task Load Index (SURG-TLX) questionnaire helps to assess the impact of several stressors on the perceived demands of surgeons during surgery. In this study, we evaluate the applicability of the SURG-TLX questionnaire for endourologic procedures and set a first point of reference. Materials and Methods: Between March and August 2022, 15 urologists and urology residents at a tertiary referral center for endourology completed the SURG-TLX questionnaire after endourologic procedures. After data acquisition, all participants were asked to evaluate the applicability of the questionnaire for endourologic procedures. Results: A total of 130 procedures were included between March and August 2022. Situational stress had the lowest median score (3.0/20; interquartile range [IQR] 2.0-7.0) and task complexity the highest (5.0/20; IQR 3.0-8.0). After weighing, the dimensions showed different proportions when compared with the nonweighted scores. Distractions received the highest score (15.0/100; IQR 7.5-32.8), temporal demands (6.0/100; IQR 3.0-12.5), and situational stress the lowest (6.0/100; IQR 2.0-21.0). This was caused by the higher weight that was attributed to distractions (3.4/5), as opposed to task complexity (2.6/5). In the questionnaire regarding applicability of the SURG-TLX, the overall satisfaction (6.0/10; IQR 5.0-7.0) and clarity (6.5/10; IQR 5.0-7.5) were moderate. The user-friendliness and applicability of the questionnaire were rated high (7.0/10; IQR 5.5-8.0 and 7.0/10; IQR 6.0-8.0, respectively) and task load (3.0/10; IQR 2.0-5.0) and time load (2.0/10; IQR 2.0-3.5) low. Conclusion: The SURG-TLX questionnaire is appropriate to assess the different dimensions of workload during endourologic procedures. Furthermore, the perceived workload during endourologic procedures is relatively low.
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Affiliation(s)
- Michaël M E L Henderickx
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Nora Hendriks
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Joyce Baard
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Harrie P Beerlage
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Daphne T Boom
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Judith Bosschieter
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - A Carolien Bouma-Houwert
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jaap D Legemate
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Jakko A Nieuwenhuijzen
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Arnoud W Postema
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Lieske H Rongen
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Brechje L Ronkes
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Matthijs J V Scheltema
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Tim M van der Sluis
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Peter G K Wagstaff
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
| | - Guido M Kamphuis
- Department of Urology, Amsterdam UMC Location University of Amsterdam, Amsterdam, The Netherlands
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Lütfrenk T, Neisius A, Rausch S, Salem J, Kuru TH. Prospective Analysis of Versatility and User Satisfaction with a Novel Single-Use Cystoscope with Working Channel. Urol Int 2023; 107:570-577. [PMID: 37071983 PMCID: PMC10871682 DOI: 10.1159/000529488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 01/30/2023] [Indexed: 04/20/2023]
Abstract
INTRODUCTION In the present study, a prospective systematic assessment of the clinical utility of the Ambu® aScopeTM 4 Cysto Reverse Deflection with regard to image quality, maneuverability, and navigation in an outpatient and inpatient setting was performed. MATERIALS AND METHODS A prospective multicenter study was performed for evaluation of the instrument during routine cystoscopy. We evaluated the clinical performance of the instruments using a standardized user questionnaire in different categories including image quality, treatment success, imaging of all areas of the urinary bladder, quality of navigation, flexibility of the endoscope, and satisfaction with the device. Statistical analyses were performed by SPSS using the Kruskal-Wallis and Wilcoxon-Mann-Whitney tests. A p value of p ≤ 0.05 was defined as statistically significant. RESULTS A total of 200 cystoscopies were performed, and the questionnaire response rate was 100%. The image quality was rated as very good in 65.5% (n = 131), good in 30.5% (n = 61), and neutral in 4% (n = 8) of cases. The criteria for poor or very poor were not mentioned. The characteristic "treatment success based on image quality" was also evaluated as very good in 49% (n = 98) and good in 50.5% (n = 101). The analysis revealed a very good or good overall impression of the examiners in all cases. Replacement of the cystoscope was not necessary during any of the examinations. However, in 3 cases, technical difficulties were documented. Further analysis of the data showed that physicians with less professional experience rated the visualization of the urinary bladder (p = 0.007) and the treatment success with regard to image quality significantly worse (p = 0.007). CONCLUSION The Ambu® aScope™ 4 Cysto Reverse Deflection shows high satisfaction values among users in clinical routine. In analogy to other studies with flexible endoscopes, urologists with more professional experience show higher satisfaction values than examiners with less training in flexible endoscopy.
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Affiliation(s)
- Thomas Lütfrenk
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Andreas Neisius
- Department of Urology, Krankenhaus der Barmherzigen Brüder Trier, Medizincampus der Universitätsmedizin Mainz, Trier, Germany
| | - Steffen Rausch
- Department of Urology, Eberhard-Karls-University, Tübingen, Germany
| | - Johannes Salem
- CUROS urologisches Zentrum, Cologne, Germany
- Department of Urology, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
| | - Timur H. Kuru
- CUROS urologisches Zentrum, Cologne, Germany
- Department of Urology, University Hospital Brandenburg, Brandenburg Medical School Theodor Fontane, Neuruppin, Germany
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Kemble JP, Winoker JS, Patel SH, Su ZT, Matlaga BR, Potretzke AM, Koo K. Environmental impact of single-use and reusable flexible cystoscopes. BJU Int 2022; 131:617-622. [PMID: 36515438 DOI: 10.1111/bju.15949] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES To compare the carbon footprint and environmental impact of single-use and reusable flexible cystoscopes. MATERIALS AND METHODS We analysed the expected clinical lifecycle of single-use (Ambu aScope™ 4 Cysto) and reusable (Olympus CYF-V2) flexible cystoscopes, from manufacture to disposal. Performance data on cumulative procedures between repairs and before decommissioning were derived from a high-volume multispecialty practice. We estimated carbon expenditures per-case using published data on endoscope manufacturing, energy consumption during transportation and reprocessing, and solid waste disposal. RESULTS A fleet of 16 reusable cystoscopes in service for up to 135 months averaged 207 cases between repairs and 3920 cases per lifecycle. Based on a manufacturing carbon footprint of 11.49 kg CO2 /kg device for reusable flexible endoscopes and 8.54 kg CO2 /kg device for single-use endoscopes, the per-case manufacturing cost was 1.37 kg CO2 for single-use devices and 0.0017 kg CO2 for reusable devices. The solid mass of single-use and reusable devices was 0.16 and 0.57 kg, respectively. For reusable devices, the energy consumption of reusable device reprocessing using an automated endoscope reprocessor was 0.20 kg CO2 , and per-case costs of device repackaging and repair were 0.005 and 0.02 kg CO2 , respectively. The total estimated per-case carbon footprint of single-use and reusable devices was 2.40 and 0.53 kg CO2 , respectively, favouring reusable devices. CONCLUSION In this lifecycle analysis, the environmental impact of reusable flexible cystoscopes is markedly less than single-use cystoscopes. The primary contributor to the per-case carbon cost of reusable devices is energy consumption of reprocessing.
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Affiliation(s)
| | | | - Sunil H Patel
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Zhuo T Su
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brian R Matlaga
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Borja Brugés CN, Rindorf DK, Cepeda M, Schultz Hansen K. Willingness to Pay and Preferences Among Patients Undergoing Cystoscopies: Results from a Large Survey-Based Study in Spain. Res Rep Urol 2022; 14:359-367. [PMID: 36281287 PMCID: PMC9587725 DOI: 10.2147/rru.s375582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/14/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose Cystoscopy procedures can cause distress among patients. Patient perspectives on health services are essential inputs in decision-making. This study investigated the patient preferences in Spain regarding single-use cystoscopes (SUC) compared to reusable cystoscopes and their willingness to pay (WTP) for cystoscopy procedures. Patients and Methods Between May and June 2021, an anonymous survey was distributed to Spanish patients who had previously undergone a cystoscopy. The survey included patient preference measures on reusable cystoscopes compared to SUCs and a discrete choice experiment. The survey was distributed through a human data science company (IQVIA), collected using an online survey tool (QuestionPro®), and analyzed using Stata/MP, StataCorp. Results Of 300 respondents, 148 (49.33%) were female and 150 (50%) were male, and mainly between 18–49 years (247, 82.33%). Most (265, 88%) preferred to have their procedure performed with a SUC rather than a reusable cystoscope. Among these patients, 215 (80%) could imagine asking their doctor to use a SUC. A total of 231 (77%) respondents indicated an increased level of concern about the risk of exposure to contamination related to their cystoscopy following the COVID-19 pandemic. Patients would pay 62 EUR to have their initial consultation and cystoscopy procedure on the same day (p < 0.001), 59 EUR to reduce the environmental impact, and 57 EUR to reduce the risk of contamination (p < 0.001). Conclusion Patients prefer to undergo cystoscopy using an SUC on the same day as their initial consultation. The increased contamination concerns due to the COVID-19 pandemic and WTP to reduce the risk of cystoscope contamination may explain patients’ preferences for SUCs. The most important attributes related to their cystoscopy procedure are the ability to have their procedure performed on the same day as their initial consultation, the reduction of the environmental impact, and the reduction of the contamination risk.
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Affiliation(s)
- Cindy N Borja Brugés
- Copenhagen Business School, Frederiksberg, Denmark,Correspondence: Cindy N Borja Brugés, Copenhagen Business School, Solbjerg Pl. 3, 2000, Frederiksberg, Denmark, Tel +45 81710059, Fax +45 72252050, Email
| | | | - Marcos Cepeda
- Department of Urology, Hospital Río Hortega de Valladolid, Valladolid, Spain
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Boucheron T, Lechevallier E, Gondran-Tellier B, Michel F, Bastide C, Martin N, Baboudjian M. Cost and Environmental Impact of Disposable Flexible Cystoscopes Compared to Reusable Devices. J Endourol 2022; 36:1317-1321. [PMID: 35703325 DOI: 10.1089/end.2022.0201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives: To quantify the environmental impact and costs associated with flexible cystoscopy procedures from an institutional perspective, with particular attention for the comparison between disposable and reusable cystoscopes. Materials and Methods: This is a single-center retrospective study, including all flexible cystoscopies performed between 2020 and 2021 using reusable or single-use devices. The Ambu aS4C single-use cystoscope (Ballerup, Denmark) gradually replaced the reusable device in our center, with exclusive use from October 2021. Reprocessing costs for reusable cystoscopes were evaluated using a micro-costing approach. The environmental impact of reusable and disposable cystoscopes was assessed by the amount of waste and water consumed for each procedure. Results: A total of 1578 flexible cystoscopies using reusable cystoscopes were performed in 2020, and 550 cystoscopies were performed using the Ambu aS4C cystoscope from October 2021 to February 2022. The cost of flexible cystoscopy with a reusable and a disposable endoscope was €196 and €192, respectively. The amount of waste generated by reprocessing reusable and disposable cystoscopes was 800 and 200 g per procedure, respectively. Water consumption for sterilization of the reusable cystoscope was 60 L per procedure, whereas no water consumption was required with the Ambu aS4C cystoscope. A 100% Ambu aS4C cystoscope use would reduce waste generation and water consumption by 946.8 kg and 94.68 m3 per year. Conclusion: In this study, implementing a strategy of using 100% disposable cystoscopes was associated with similar costs and reduced waste generation and water consumption compared to reusable devices. Future studies are needed to compare the carbon footprint of these devices, through a comprehensive and rigorous life cycle assessment from manufacturing to recycling.
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Affiliation(s)
- Tiphaine Boucheron
- Pharmacy Department, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Eric Lechevallier
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Bastien Gondran-Tellier
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Floriane Michel
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Cyrille Bastide
- Department of Urology, North Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Nathalie Martin
- Pharmacy Department, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
| | - Michael Baboudjian
- Department of Urology, La Conception Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Department of Urology, North Hospital, Assistance Publique-Hôpitaux de Marseille (AP-HM), Marseille, France
- Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain
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Kalipershad SNR, Subar DA, Date RS. The feasibility of disposable video‐bronchoscopes, Ambu aScope3, for exploration of the common bile duct and extraction of stones. DEN OPEN 2022; 2:e67. [PMID: 35310694 PMCID: PMC8828166 DOI: 10.1002/deo2.67] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 09/08/2021] [Accepted: 09/26/2021] [Indexed: 11/30/2022]
Abstract
Introduction The aim of this study was to assess and evaluate the feasibility of using the Ambu aScope3 (aScope) for common bile duct (CBD) explorations, stone detection and extraction, as well as to assess feasibility of its use through the laparoscopic ports in a low‐volume centre. Methods This is a dual centre prospective study, conducted between February 2015 and August 2019, of patients undergoing laparoscopic cholecystectomy and common bile duct exploration. Ethical approval was obtained from the North West ‐ Greater Manchester South Research Ethics Committee. All patients were counselled on the use of the aScope in clinic, prior to surgery. The Primary endpoints were the ability of the aScope to identify CBD stones, perform a cholangiogram through the available channel, retrieve the stones using a Dormia basket and to visualise second generation biliary radicles satisfactorily. The secondary endpoint was the use of the aScope, via a laparoscopic port without a gas leak. The data collected included patient demographics, need for a CBD exploration, intraoperative confirmation of CBD stones and their safe extraction using an aScope. Results A total of nine patients were recruited. The aScope provided satisfactory views in eight of nine patients and enabled the safe extraction of CBD stones in six of nine cases. One patient had a bile leak, and another had a transected CBD prior to the use of the aScope. Conclusion We found that the aScope is a safe, feasible alternative to a choledochoscope, and in a low‐volume centre, it provides a financially viable option.
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Affiliation(s)
| | - Daren A. Subar
- Department of Surgery East Lancashire Teaching Hospitals NHS Trust Lancashire UK
| | - Ravindra S. Date
- Department of Surgery Lancashire Teaching Hospitals NHS Foundation Trust Lancashire UK
- The University of Manchester Manchester Academic Health Science Centre Manchester UK
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