The new Avicenna Roboflex: How does the irrigation system work? Results from an in vitro experiment

  • Salvatore Butticè | salvobu@gmail.com Pierre & Marie Curie University, Tenon University Hospital, Paris, France; Department of Urology, San Giovanni di Dio Hospital, Agrigento, Italy; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .
  • Bahadir Sahin Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .
  • Tarik Emre Sener Department of Urology, School of Medicine, Marmara University, Istanbul, Turkey; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .
  • Laurian Dragos Department of Urology, Emergency County Hospital, Pius Branzeu, Timisoara, Romania; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .
  • Silvia Proietti Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .
  • Steeve Doizi Pierre & Marie Curie University, Tenon University Hospital, Paris, France; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .
  • Olivier Traxer Pierre & Marie Curie University, Tenon University Hospital, Paris, France; PETRA UroGroup, Progress in Endourology, Technology and Research Association, .

Abstract

Introduction: Since 2012 Elmed has been working on a robot specifically designed for flexible ureteroscopy. After the first version of Avicenna Roboflex, a second version was developed in 2015, with significant changes especially in the irrigation system. We consider mandatory for the endourologist that works with the Avicenna Roboflex be aware of the functioning of the irrigation system. Materials and Methods: We connected a container to the pump’s irrigation system and measured the quantity of saline per second delivered by each speed setting, with/without the flush in five different modalities: pump on its own, pump with ureteroscope, with two laser fibers, with 1.9 Fr basket, and with a Terumo guidewire. Results: The highest mean flow-rates were observed in the 200- micrometer laser fiber, after the pump on its own. Median flowrates for all speed settings were significantly higher for the pump on its own than for the URS in both flushed and nonflushed modes (p = 0.045, p = 0.039 respectively). There was no statistically significant difference in median flow-rates between the guide wire and basket in all of the speed settings (p = 0.932 and p = 0.977). For both laser fibers there was no statistically significant difference between the median flow rate on both nonflush and flush modes. (p = 0.590 & p = 0.590). There was a linear correlation between the speed setting and the increase measured with the flush-option for pump only measurements (r = 0.602, p = 0.038). There was no statistically significant difference between laser fibers and the pump on its own on the increase of flow rate with flush mode. (p = 0.443 for the 272- micrometer fiber and p = 0.219 for the 200-micrometer fiber). Conclusion: The irrigation system of the new Avicenna Roboflex is optimized compared to the previous version. However other more complex studies concerning the live flow/pressure relationship are needed before firm conclusions can be made.

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Published
2018-09-30
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Section
Original Papers - Stones and Infections
Keywords:
Renal Stone, Ureteroscopy, Avicenna Roboflex, Irrigation System, Flexible Ureteroscopy, Intrarenal Flow, Urolithiasis.
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How to Cite
Butticè, S., Sahin, B., Sener, T. E., Dragos, L., Proietti, S., Doizi, S., & Traxer, O. (2018). The new Avicenna Roboflex: How does the irrigation system work? Results from an in vitro experiment. Archivio Italiano Di Urologia E Andrologia, 90(3), 155-158. https://doi.org/10.4081/aiua.2018.3.155