Ambu aScope 4 Cysto

Emerging Technologies

Why Duke University Urologists Prefer Single-Use

The department began using the aScope 4 Cysto for inpatient bedside procedures during the COVID-19 pandemic to reduce potential viral spread. It remains the primary flexible cystoscope employed in these procedures and “continues to gain positive feedback.”

A new single-use cystoscope demonstrated superior flexion and comparable optics to the reusable scopes already being used in a hospital urology department.

The single-use scope, the Ambu aScope 4 Cysto, also compared favorably in initial inpatient bedside use.

Those conclusions were reached by researchers in the division of urology at Duke University Hospital, where they performed a benchtop and initial clinical analysis.

Inpatient Procedures

Data recorded from 17 inpatient bedside procedures — 10 performed with single-use cystoscopes and seven with reusable — rated the aScope 4 Cysto higher in visibility, flexion, desire to use again, and overall score. There was no need to switch to a reusable cystoscope for any procedure and no reported complications relating to any scopes.

The department began using the aScope 4 Cysto for inpatient bedside procedures during the COVID-19 pandemic to reduce potential viral spread. It remains the primary flexible cystoscope employed in these procedures and “continues to gain positive feedback,” according to the study.

Benchtop Testing

The single-use cystoscope exceeded 200 degrees in median upward flexion and 160 degrees in median downward flexion, both while empty and with tools inside its channel.

The aScope 4 Cysto exceeded reusable cystoscopes by about 20 and 70 degrees in upward and downward flexion, respectively. This is significant, according to the researchers, because reusable scopes likely lose flexion over time even though they’re not designed for repair.

Each reusable cystoscope tested was at least five years old and had undergone seven repairs in that span. The others had undergone two or fewer repairs in the last five years.

“In most clinical scenarios, a brand-new reusable scope is not available, and the urologist must use what is at their disposal,” the researchers write. “This may raise the potential benefit of a ‘brand-new’ scope for each procedure that a single-use scope provides.”

The optics comparison revealed:

  • Single-use offered superior vision at 50 mm compared with the HD reusable cystoscope
  • No difference between optics of single-use and reusable HD scopes at 30 and 10 mm
  • HD reusable scope offered better optics at 3 and 5 mm
  • Single-use scope was superior to SD reusable cystoscope at 5, 10, 30, and 50 mm
  • Single-use scope has superior depth of field than SD reusable cystoscope
  • No difference in distortion between single-use and HD or SD reusable cystoscopes

Ambu, the manufacturer of the aScope 4 Cysto, did not fund this study. 

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