Unleashing the Powerful Load Bending Capacity with BendForce Enhancement Technology-the Game-Changing 7.5Fr CoralView® Single-Use Ureteroscope by MacroLux

Introduction

The incidence of urinary system stones has been progressively increasing, while the management approaches have been gradually transitioning towards minimally invasive procedures. Flexible Ureteroscopy Lithotripsy (FURL) achieves a transition from artificial passages to natural passages and is currently considered the safer and less invasive method for treating upper urinary tract stones.

Details

Fig 1. A stone is pulled from the ureter using a basket

The routine utilization of the Ureteral Access Sheath (UAS) during FURL is recommended to facilitate the passage of the ureteroscope in and out of the urinary tract, thereby enabling continuous drainage and improving visualization. However, limitations such as uncontrollable intrarenal pressure (IRP) and suboptimal postoperative SFR still exist.

Fig 2. A thin, flexible tube allows your doctor to access all renal calyces for stone exploration

Limitations of Conventional UAS

Continuous irrigation is required during stone fragmentation to maintain clear visualization. Poor drainage can lead to increased intrarenal pressure (IRP), and a higher risk of postoperative infection.

FURL procedures for large stones tend to have longer operation times. The formation of a "snowstorm" during the procedure can hinder visualization and result in incomplete stone fragmentation.

When treating stones in the lower calyx, UAS can only be positioned at the junction between the renal pelvis and the ureter, using a stone retrieval basket for stone extraction. The efficiency is often suboptimal.

Dealing with larger stones increases the probability of postoperative formation of steinstrasse- a “stone street”, leading to higher costs for secondary surgical interventions and reduced patient satisfaction.

Fig 3. Conventional sheaths are not flexible and cannot reach deep into the renal calyx

With the increasing popularity of FURL, UAS has undergone continuous updates and advancements. The novel bendable negative-pressure suction sheath actively reduces intrarenal pressure (IRP) and can follow the flexible scope in and out of the target renal calyx, extracting fragmented stone particles while maintaining a clear field of view.

Fig 4. Bendable negative-pressure suction sheath

Fig 5. The tip-bendable suction UAS can provide better surgical vision when compared with the conventional UAS

Despite the numerous advantages of the bendable negative pressure sheath, the quality of currently available bendable sheaths and ureteroscopes with sufficient bending capability vary in the market. For cases involving larger angled renal calyces, when the ureteroscope lacks sufficient deflecting power, it necessitates the replacement of a larger OD ureteroscope to increase the bending capacity. Therefore, the development of an ultra-thin ureteroscope with powerful deflection capability to accommodate the bendable negative pressure sheath becomes crucial and urgent.

Fig 6. Other brands of ureteroscopes unable to drive the bendable Ureteral Access sheath

MacroLux Medical has introduced the CoralView® 7.5Fr Single-Use Digital Flexible Ureteroscope, with powerful load bending capacity by BendForce Enhancement Technology developed independently. The insertion tube is constructed using high-strength materials, providing powerful deflection capability to accommodate the bendable negative pressure sheath.

Fig 7. The powerful deflection capability of the MacroLux 7.5Fr ureteroscope - Strong Scopes, Effortlessly Driving UAS Along

Even under a load of 200 μm laser fiber or stone retrieval basket, the CoralView® Single-Use Digital Flexible Ureteroscope can still achieve 275° optimal angles in both upward and downward directions.

Fig 8. CoralView® 7.5Fr Single-Use Digital Flexible Ureteroscope bending for 275° with 200μm optical fibers and baskets.

Advantages of BendForce enhancement of CoralView®

A combination of a 7.5Fr single-use FURS and a 10/12Fr bendable negative-pressure suction sheath can achieve the optimal scope/sheath ratio (≤0.75). This can maintain low IRP throughout the procedure without increasing the risk of postoperative infection.

The sheath can smoothly reach the upper and middle renal calyces, allowing aspiration within narrow calyceal spaces. For lower calyces, the sheath can be positioned at the neck of the calyx, allowing high-pressure irrigation to wash out and aspirate stones. This approach reduces the overall surgical time.

Even when loaded with laser fibers or baskets, it maintains a reliable bending angle of 275°, enabling precise positioning and fragmentation of stones deep within the renal pelvis, thereby improving the stone clearance rate.

By reducing the use of stone retrieval baskets during the procedure, the cost of surgery is decreased. Additionally, the prevention of stone streets reduces the need for secondary surgical interventions and enhances patient satisfaction.

With the ideal sheath/scope ratio and bending force, CoralView® Single-Use Digital Flexible Ureteroscope perfectly meets the clinical demands of the current FURL development in the field of urology stone management. We welcome further clinical usage experiences and evidence to validate the performance of the CoralView® Single-Use Digital Flexible Ureteroscope. We eagerly anticipate feedback from the medical community, as it will contribute to the ongoing refinement and enhancement of our product.

MacroLux Medical has always adhered to the vision of " Healing for life, and life for healing." We aim to offer novel endoscopic interventional diagnostic and therapeutic technologies on a global scale. We are committed to researching and promoting new medical technologies to provide better care for every life.

REFERENCE

Kang DH, Cho KS, Chung DY, Jeong WS, Do Jung H, Kim DK, Lee JY. Stone-free rates of mPCNL, PCNL, and RIRS: A systematic review and network meta-analysis. Urogenital Tract Infection. 2022 Apr 30;17(1):14-25.
Liang H, Liang L, Lin Y, Yu Y, Xu X, Liang Z, Sheng J, Shen B. Application of tip-bendable ureteral access sheath in flexible ureteroscopic lithotripsy: an initial experience of 224 cases. BMC urology. 2023 Nov 1;23(1):175.
Zeng G, Wang D, Zhang T, Wan SP. Modified access sheath for continuous flow ureteroscopic lithotripsy: a preliminary report of a novel concept and technique. Journal of endourology. 2016 Sep 1;30(9):992-6.

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Unleashing the Powerful Load Bending Capacity with BendForce Enhancement Technology-the Game-Changing 7.5Fr CoralView® Single-Use Ureteroscope by MacroLux