Clinical Scorecard: Evaluation of a Novel Digital Disposable Semirigid Nephroscope for Suction Mini-Percutaneous Nephrolithotripsy: A Feasibility Assessment
Use of a digital disposable semirigid nephroscope integrated with suction mini-PCNL to enhance stone fragmentation and extraction
Target Population
Patients of all ages with renal stones undergoing suction mini-PCNL
Care Setting
Single-center urology clinic with operative and postoperative follow-up
Key Highlights
The Redpine™ digital disposable nephroscope offers ergonomic, lightweight design with high-quality imaging and a large working channel in a slim 13.2 Fr shaft.
Suction mini-PCNL (14-22 Fr access) aims to reduce morbidity compared to standard PCNL by minimizing incision size and tissue manipulation.
The device is autoclavable and suitable for multiple uses under strict sterilization, combining benefits of disposable and reusable scopes.
Guideline-Based Recommendations
Diagnosis
Preoperative assessment with low-dose non-contrast CT scan with bone window to evaluate stone size, volume, location, and density.
Preoperative urine culture and treatment of infections prior to surgery.
Management
Use of digital disposable nephroscope in suction mini-PCNL with fluoroscopic guidance for tract access.
Positioning patients supine or prone based on surgical plan.
Use of 14-22 Fr suction nephrostomy sheaths per International Alliance of Urolithiasis guidelines.
Management of anticoagulants/antiplatelets by stopping 3-7 days before surgery and restarting as needed.
Monitoring & Follow-up
Assessment of operative time, lithotripsy time, and surgeon experience using a 5-point Likert scale.
Postoperative pain assessment within 24 hours using a 10-point visual analog scale.
30-day complication grading using Clavien-Dindo classification.
Stone-free status evaluation at 4 weeks postoperatively by low-dose NCCT scan.
Risks
Potential complications graded by Clavien-Dindo score within 30 days postoperatively.
Consideration of comorbidities such as chronic kidney disease and diabetes in perioperative management.
Patient & Prescribing Data
328 patients undergoing suction mini-PCNL with digital disposable nephroscope, median age 46 years, majority ASA score 1, including patients with CKD and on anticoagulants.
The device demonstrated feasibility and safety in diverse stone burdens with favorable surgeon-rated ergonomics and imaging quality; protocol adherence ensured management of comorbidities and anticoagulation.
Clinical Best Practices
Strict adherence to sterilization protocols for the digital disposable nephroscope to allow safe reuse.
Preoperative planning including imaging and infection control to optimize surgical outcomes.
Use of fluoroscopic guidance and appropriate sheath size tailored to patient anatomy and stone burden.
Systematic postoperative monitoring including pain assessment and imaging to evaluate stone clearance and complications.
