Background: Recently a novel omnidirectional (OD) ureteral access sheath (UAS) has been developed. By retrospectively reviewing and comparing the flexible ureteroscopic lithotripsy (FURL) cases in our institution with either a conventional Cook UAS or an OD UAS in the past year, we shared our experience of the safety, efficacy, and relevant issues on the usage of OD UAS. Materials and Methods: The medical history and surgery details of 199 patients with kidney stones or ureterojunctional stones who underwent FURL in Xinhua Hospital, including 61 Cook UAS and 138 OD UAS, were reviewed and compared. The maximal deflection angle was measured by steering four different types of ureteroscopes to bend the OD UAS in different states. Result: The deflection angle of OD UAS was ∼110° to 130° free load, and 90° to 130° when loaded with different instruments. The stone burden and position were similar in two groups. Given a similar prestent ratio and operation time, the OD UAS group achieved a higher single-session stone-free rate (SFR) (63.9% vs 94.2%, p < 0.0001) at 1-month follow-up evaluated by a CT scan. Conclusion: OD UAS is a novel device with high safety and efficacy. The unique flexible design allows it to bend with the ureteroscope and enter renal calices and be set close to the stone. Combined with the suction port, OD UAS contributes greatly to dealing with large-burden kidney stones, shortens operation time, and improves single-session SFR.

中文翻译：

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全向（柔性）输尿管通路鞘：安全性、有效性和初步经验报告。

背景：最近开发了一种新型全向（OD）输尿管通路鞘（UAS）。通过对过去一年来我院使用传统库克无人机或OD无人机进行输尿管软镜碎石术（FURL）的病例进行回顾和比较，我们分享了OD无人机使用安全性、有效性和相关问题的经验。 。材料与方法：对在新华医院接受FURL治疗的199例肾结石或输尿管结合部结石患者的病史和手术细节进行回顾和比较，其中Cook UAS 61例，OD UAS 138例。通过操纵四种不同类型的输尿管镜在不同状态下弯曲 OD UAS 来测量最大偏转角。结果：OD UAS空载时的偏转角为~110°至130°，当加载不同仪器时偏转角为90°至130°。两组的结石负荷和位置相似。鉴于相似的现有比率和手术时间，在通过 CT 扫描评估的 1 个月随访中，OD UAS 组取得了更高的单次无结石率 (SFR)（63.9% vs 94.2%，p < 0.0001）。结论：OD UAS是一种安全性高、有效性高的新型装置。独特的柔性设计使其能够随输尿管镜弯曲并进入肾盏并靠近结石放置。OD UAS与吸引口相结合，对于处理大负荷肾结石、缩短手术时间、提高单次SFR有很大帮助。