Comparison of nitinol tipless stone baskets in an in vitro caliceal model

Stephen Lukasewycz, Jason Skenazy, Nathan Hoffman, Michael Kuskowski, Kari Hendlin, Manoj Monga

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Purpose: Tipless stone baskets facilitate caliceal calculi extraction during flexible ureteroscopy. We evaluated the stone capture rate of 9 commercially available tipless stone baskets in an in vitro model using novice and expert operators. Materials and Methods: The Microvasive Zerotip (2.4Fr, 3.0Fr), Cook N-Circle (2.2Fr, 3.0Fr, 3.2Fr), Bard Dimension (3.0Fr, Sacred Heart Medical Halo (1.9Fr), Vantage (1.9Fr) and Circon-ACMI Sur-Catch-NT (3.0Fr) were tested by 3 novice and 3 experienced basket operators. Each operator performed stone extraction of 2, 5 and 8 mm calculi (size determined by digital caliper with 3 repetitions of each basket. The time to extraction of the calculus from a convex based test tube caliceal model was recorded. Statistical analysis was performed using repeated measures ANOVA and Fisher's pairwise comparisons. Results: After a learning curve of 27 basket retrievals, there was no significant difference in stone capture times between novice (38 ± 54 seconds) and expert operators (32 ± 49 seconds, p = 0.174). For total stone capture (all sizes) the Sacred Heart Halo resulted in the most rapid stone extraction (17 ± 14 seconds) by novices and experts, while the Sur-Catch NT resulted in the slowest stone extraction (78 ± 90, seconds, p = 0.001). The Halo (14 ± 9 seconds) and Vantage (19 ± 12 seconds) baskets were significantly faster for 2 mm calculi than the N-Circle (73 ± 60 seconds, p = 0.006), Sur-Catch (169 ± 85 seconds, p = 0.0005) and Dimension (73 ± 70 seconds, p = 0.017). The Zerotip functioned well for 2 mm calculi in the hands of expert operators (15 ± 9 seconds) but not novice operators (94 ± 95 seconds). The Sur-Catch NT was significantly slower for 2 mm calculi than the N-Circle (p = 0.01), Dimension (p = .03), Halo (p = .0005), Vantage (p = .001) and Zerotip (p = .002). For 5 mm calculi the Halo was superior (12 ± 8 seconds), while the Zerotip were superior for 8 mm calculi (8 ± 3 seconds) compared to the N-Circle (23 ± 28 seconds, p = 0.026), Halo (26 ± 18 seconds, p = 0.021) and Vantage (23 ± 15 seconds, p = 0.006). Conclusions: The Sacred Heart Halo and Vantage baskets resulted in the most expeditious stone extraction, especially for 2 to 5 mm calculi while the Microvasive Zerotip was optimal for 8 mm calculi. The Sur-Catch NT had the slowest stone capture rate for all stone sizes. Caliceal models of stone basketing may be useful to train novice urology residents and nursing assistants.

Original languageEnglish (US)
Pages (from-to)562-564
Number of pages3
JournalJournal of Urology
Volume172
Issue number2
DOIs
StatePublished - Aug 2004

Keywords

  • Instrumentation
  • Kidney calculi
  • Ureteroscopy

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