ArticleWorld journal of urology2024
Optimal deflection techniques for flexible and navigable suction ureteral access sheaths (FANS): a comparative in vitro PEARLS analysis.
Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and safety of the flexible negative-pressure ureteral sheath in retrograde intrarenal surgery: a systematic review and meta-analysis.Frontiers in surgery · 2025Pooled it
- Efficacy of 6. 3Fr disposable digital flexible ureteroscope versus 7. 5Fr disposable digital flexible ureteroscope in the treatment of upper urinary tract stones < 1. 5 cm: a randomized controlled trial.World journal of urology · 2025Trial
- Is flexible navigable suction ureteral access sheath (FANS) safer and more efficient than conventional sheaths? Italian multicentric experience.World journal of urology · 2025Trial
- Article
- Outpatient versus inpatient flexible ureteroscopy with flexible and navigable suction access sheath: A multicenter comparative analysis of perioperative outcomes from the flexible and navigable access sheath collaborative study group.Asian journal of urology · 2026Article
- Comparison of Flexible and Navigable Suction Ureteral Access Sheath Versus Conventional Ureteric Access Sheath in RIRS: A Systematic Review and Meta-Analysis.Urology research & practice · 2026Article
- Benchtop comparison of seven ureteroscopes: evaluating physical properties and deflection with flexible and navigable suction access sheaths.BJU international · 2026Article
- Flexible and navigable suction access sheaths: what size stone particles can be cleared?BJU international · 2026Article
- Efficacy analysis of a flexible-tip vacuum sheath combined with a 7.5F single-use digital ureteroscope in the treatment of upper urinary tract stones.Translational andrology and urology · 2026Article
- Flexible and navigable suction ureteral access sheath's impact on ureteroscope deflection.World journal of urology · 2026Article
- How do we choose the optimal length of flexible and navigable suction ureteral access sheaths (FANS): an EAU endourology and AUSET prospective multicenter analysis.World journal of urology · 2026Article
- Intrarenal pelvic pressure and renal temperature during 6.3Fr disposable digital flexible ureteroscope surgery: an in vitro experiment.Urolithiasis · 2025Article
- Aspiration properties of flexible and navigable suction ureteral access sheath (FANS) and flexible ureteroscope with direct-in-scope suction (DISS): an in-vitro experimental study by EAU young academic urologists (YAU) urolithiasis and endourology working group.International urology and nephrology · 2025Article
- In-vitro deflection comparison of 3 Flexible and Navigable Suction Ureteral Access Sheaths (FANS) of 2 sizes across 7.5Fr single-use flexible ureteroscopes: an AUSET-EAU endourology collaboration.World journal of urology · 2025Article
- Machine learning models to predict the zero-fragment rate and lower pole access with FANS during flexible Ureteroscopy-an EAU section of endourology study.World journal of urology · 2025Article
- Impact of flow rate and ratio of endoscope-sheath diameter on stone removal in flexible ureteroscopic lithotripsy: in vitro and CFD analyses insights.International urology and nephrology · 2025Article
- Single-use versus reusable flexible ureterorenoscopes with FANS: a multicenter propensity-matched analysis of outcomes in a large series from the EAU-Endourology Section and FANS Collaborative Group.World journal of urology · 2025Article
- High-frequency in laser lithotripsy: do we truly know what it means?World journal of urology · 2025Review
- Direct-in-scope suction with a 5.1Fr large working channel ureteroscope: what stone dust size for effective evacuation during laser lithotripsy? An in vitro analysis by PEARLS and section of EAU Endourology.World journal of urology · 2025Article
- The utility of flexible and navigable suction access sheath (FANS) in patients undergoing same session flexible ureteroscopy for bilateral renal calculi: a global prospective multicenter analysis by EAU endourology.World journal of urology · 2025Article
Corrections and comments
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Authors and funding
12 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeFlexible and navigable suction ureteral access sheaths (FANS) have been introduced without current evidence on how to optimize deflection. Aim was to evaluate in vitro deflection angles with 2 different FANS techniques-sheath advancement and ureteroscope deflection; and effects of sheath size-ureteroscope combinations.
methodsWe evaluated in vitro deflection angles of 10/12Fr, 11/13Fr and 12/14Fr FANS (Hunan Reborn Medical Co. Ltd) with six single-use flexible ureteroscopes (Pusen Uscope 7.5Fr, OTU WiScope 7.5Fr, OTU WiScope 8.6Fr, Innovex EU-scope 8.7Fr, Red Pine RP-U-C12 8.7Fr and Boston Scientific Lithovue 9.5Fr). Two deflection techniques were tested: (1) sheath advancement-advancing the sheath forward over a maximally deflected ureteroscope, and (2) ureteroscope deflection-maximally deflecting the ureteroscope from various starting positions relative to tip of the sheath.
resultsIntra and inter-scope comparisons of maximum deflection angles were significantly different (all ANOVA p < 0.01). Largest maximum angles for all ureteroscopes were with the sheath advancement technique (range 218°-277°), and second largest for most scopes using the ureteroscope deflection technique at tip (range 111°-212°), mostly deviating from manufacturer specifications (range 270°-275°). 10/12Fr and 11/13Fr sheath sizes were more flexible than 12/14Fr. Largest angles were with 11/13Fr sheath-OTU8.6Fr/Innovex8.7Fr combinations.
conclusionOptimal deflection with FANS is achieved using either a sheath advancement technique, or ureteroscope deflection technique at tip. Despite using these optimized techniques, deflection angles specified by manufacturers seem hardly achievable. The sheath advancement technique and 11/13Fr sheath-OTU8.6Fr/Innovex8.7Fr combinations may be better suited for lower pole situations. Urologists should be aware of these differences and apply the findings to their FANS technique.
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