ArticleWorld journal of urology2026
Real-time monitoring with DISS and FANS systems to assure safe and effective stone treatment: Insights from ex-vivo experimental study from EAU endourology.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the real-time safety profile and intrarenal pressure (IRP) dynamics of two suction-assisted ureteroscopic systems, the Direct In-Scope Suction (DISS) and Flexible and Navigable Suction (FANS) ureteral access sheath, in an ex-vivo model. MATERIALS AND
methodsFour porcine kidney-ureter units were used, harvested from two female pigs (32-34 kg). A 20G intravenous catheter was inserted into the middle calyx for continuous IRP monitoring via a pressure transducer and monitor. Each kidney underwent four experimental configurations combining 7.5 Fr PU3033AH or 9.2 Fr PU400A DISS scopes with 9.5/11.5 Fr or 12/14 Fr FANS sheaths. Irrigation was performed using a manual hand pump, and suction was applied at 100 mmHg either through the ureteroscope or sheath. Measurements included baseline and maximal IRPs, suction-induced changes, mucosal injury, and time to endoscopic stone-free status (ESFS).
resultsSixteen experiments were completed. Activation of suction consistently reduced IRP across all settings. The The 7.5 Fr DISS + 9.5/11.5 Fr FANS configuration achieved the lowest pressures (4-12 mmHg) but caused pelvicalyceal collapse and six mucosal injuries. In contrast, the 9.2 Fr DISS + 12/14 Fr FANS combination-maintained IRP between 12 and 28 mmHg with efficient fragment evacuation and minimal collapse.
conclusionBoth DISS and FANS effectively maintained IRP within a safe range. Controlled, balanced suction was crucial for safety, while excessive negative pressure or prolonged manual irrigation risked collapse and mucosal injury. The 9.2 Fr DISS + 12/14 Fr FANS configuration demonstrated stable pressure control and efficient performance in this experimental model.
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