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Flexible ureteroscope capable of acute-angled and balanced omnidirectional bending based on soft and flexible porous tube and crossed control wiring

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Abstract

Flexible ureteroscopes (fURSs) have performance limitations in accessing acute-angled calyxes and omnidirectional bending. We propose and develop a fURS based on a soft and flexible porous tube and crossed control wiring to overcome these limitations. The fURS prototype comprises a flexible solid polyamide-12 tube and a stretch-retractable expanded polytetrafluoroethylene distal tube with 40% porosity connected by a unique cylindrical wire-routing hook (CWH). The series tube includes four crossed but not contacting loop-formed control wires to provide balanced omnidirectional bending and optimized distal tube bending performance. Bending performance was assessed compared with a conventional fURS, and feasibility studies were performed using a renal phantom. The prototype achieved a 275° omnidirectional maximum bend angle by combining up-down and right-left directions. The bent shape was more compact than the conventional fURS. Thus, the prototype achieved approximately a 1.6-fold larger maximal active bending angle within the restricted environment and a 5.5-fold larger passive bending angle. The crossed control wiring design reduced CWH offset distance by about 75% compared with conventional straight wire routing. The prototype exhibited considerably improved steering performance, exemplified by its ability to access an acutely angled calyx. Our design could improve treatment outcomes and shorten operation times associated with calyceal stone removal.

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Funding

This work was partially supported by JSPS KAKENHI, grants 18H01408 and 21K03965.

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  1. Department of Research and Development for Innovative Medical Devices and Systems, Shiga University of Medical Science, Shiga, 520-2192, Japan

    Atsushi Yamada & Tohru Tani

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  1. Atsushi Yamada
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Correspondence to Atsushi Yamada.

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Atsushi Yamada and Tohru Tani received funding from Nipro Co., Ltd. for this research project.

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Yamada, A., Tani, T. Flexible ureteroscope capable of acute-angled and balanced omnidirectional bending based on soft and flexible porous tube and crossed control wiring. Med Biol Eng Comput 61, 799–809 (2023). https://doi.org/10.1007/s11517-022-02762-2

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