ArticleBJU international2025
Characterisation of vent designs in flexible and navigable suction ureteric access sheaths.
Article in BJU international, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Efficacy and Safety of Flexible and Navigable Suction Ureteral Access Sheath Versus Conventional Ureteral Access Sheath in Retrograde Intrarenal Surgery: An Updated Systematic Review and Meta-Analysis.Medicina (Kaunas, Lithuania) · 2026Pooled it
- In vitro performance of the Vortex Intelligent Stone Optimized Removal (VISOR) system versus the flexible and navigable suction ureteral access sheath (FANS) on stone clearance efficiency and intrarenal pressure control.World journal of urology · 2026Article
- Paradigm shifts in fluid management using suction irrigation pressure autoregulating systems in modern flexible ureteroscopy with flexible and navigable suction access sheath: an evidence-based narrative from EAU Endourology.Current opinion in urology · 2026Review
- Endoscopic visual cues of intrarenal pressure during ureteroscopy: in vivo porcine studies.BJU international · 2026Article
- Article
- Intrarenal pressure response to suction during ureteroscopy with a flexible and navigable suction sheath: in vivo porcine studies.Urolithiasis · 2026Article
- Flexible and navigable suction access sheaths: what size stone particles can be cleared?BJU international · 2026Article
- Flexible and navigable suction access sheaths: balancing sheath and scope size for desired flows.BJU international · 2026Article
- Experimental stone clearance with in-scope suction and flexible and navigable suction access sheaths.BJU international · 2026Article
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Authors and funding
6 authors.
Funding
Abstract
objectivesTo evaluate the different vent designs in three commercially available flexible and navigable suction (FANS) access sheaths-ClearPetra® (Well lead, Guangzhou, China), Elephant II (YIGAOMedical, Hangzhou, China) and Tuohy-Borst FANS access sheath (Seplou, Zhejiang, China)-and quantify the effects these differing designs have on the control of suction.
methodsWe conducted benchtop experiments to quantify the effect of pressure vent design on suction pressure control. Suction experiments were conducted both in an atmospheric beaker and in a phantom kidney model. With an indwelling 9.5-F LithoVue™ (Boston Scientific, Marlborough, MA, USA) ureteroscope, constant suction was applied to the access sheath's suction port. The vents were incrementally closed and corresponding flow rates calculated as a proxy for suction pressure. A mathematical model was developed to predict the impact of pressure control vent design on suction pressure control, flow rates and intrarenal pressure.
resultsFor both the ClearPetra and Elephant II suction access sheaths, opening the length of the vent has an exponential reduction in suction pressure. Negligible suction is exerted on the renal pelvis with ≥3 mm of vent open. The Seplou suction access sheath has a Tuohy-Borst pressure vent, which allows finer control of suction pressures. The mathematical model showed strong agreement with experimental data.
conclusionCommercially available FANS access sheaths are similar in most aspects but have differing vent designs. With the vents open no suction is exerted on the renal collecting system. However, because the flexible access sheath intrarenal end is within the renal pelvis, outflow resistance is low and the pelvis will deflate, giving the impression of suction. We have developed a mathematical model that predicts flow at different suction pressures and with different degrees of the pressure vents open. This allows simulations across multidimensional parameter spaces and the resulting quantitative predictions can be exploited to assess the implications of FANS access sheath and ureteroscope design.
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