Efficacy and safety of bilateral same session flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS) versus conventional access sheath: a prospective randomized comparative study - Report - MDSpire
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Efficacy and safety of bilateral same session flexible ureteroscopy using flexible and navigable suction ureteral access sheath (FANS) versus conventional access sheath: a prospective randomized comparative study
Efficacy and Safety of FANS vs Traditional Sheath in Bilateral Flexible Ureteroscopy
Overview
This prospective randomized study compared the flexible and Navigable Suction Ureteral Access Sheath (FANS) with traditional ureteral access sheaths (TUAS) in simultaneous bilateral flexible ureteroscopy. Results demonstrated that FANS improved stone-free rates and reduced operative time without increasing adverse events, suggesting superior efficacy and safety.
Background
Bilateral renal stone disease affects approximately 15% of patients with newly diagnosed stones, necessitating effective surgical interventions. Flexible ureteroscopy has become preferred over traditional methods like PCNL due to reduced trauma and shorter hospital stays. Simultaneous bilateral flexible ureteroscopy further optimizes operative efficiency but raises concerns about ureteral injury. Traditional access sheaths have limitations including residual stone fragments, prompting development of the flexible and Navigable Suction Ureteral Access Sheath (FANS) to enhance outcomes.
Data Highlights
Parameter
Group A (TUAS)
Group B (FANS)
Number of cases
60
60
Stone-free rate Grade A (absolute free)
Lower
Higher
Operative time
Longer
Shorter
Adverse events incidence
Comparable
Comparable
Key Findings
FANS demonstrated significantly higher stone-free rates compared to traditional sheaths in bilateral flexible ureteroscopy.
Operative times were reduced in the FANS group, indicating improved procedural efficiency.
The incidence of intraoperative and postoperative adverse events was similar between FANS and traditional sheath groups, indicating comparable safety profiles.
FANS’ flexible distal segment allows up to 270° bending, facilitating better access and stone clearance.
Simultaneous bilateral flexible ureteroscopy with FANS reduces overall anesthesia exposure and hospital stay duration.
Clinical Implications
The use of FANS in simultaneous bilateral flexible ureteroscopy offers enhanced stone clearance and shorter operative times without increasing complication risks. Clinicians may consider adopting FANS technology to improve patient outcomes and procedural efficiency in managing bilateral upper tract stones under 20 mm.
Conclusion
FANS represents a promising advancement over traditional ureteral access sheaths, combining improved efficacy with maintained safety in bilateral same-session flexible ureteroscopy. Its adoption could optimize surgical management of bilateral renal stones.
References
Benha University Hospitals Prospective Study 2024 -- Comparative Analysis of FANS vs Traditional Sheath
