A feasibility study on utility of a new digital disposable semirigid nephroscope for Suction mini-percutaneous nephrolithotripsy

PURPOSE: ) during suction mini-percutaneous nephrolithotomy (SM-PCNL) for renal stones. METHODS: Between March 2024 and March 2025, 328 patients underwent SM-PCNL using the digital disposable nephroscope across institutions. Inclusion criteria encompassed all consenting patients with renal stones managed via prone/supine SM-PCNL (14-22 Fr suction sheath). The digital disposable scope served initially as a cystoscope to place the guidewire and later used for nephroscopy. Data collected included patient/stone characteristics, operative details (lithotripsy time, access technique), complications (Clavien-Dindo), surgeon satisfaction (5-point Likert scale), and stone-free rate (SFR). SFR was assessed via low-dose CT at 30 days (Grade A: no fragments; Grade B: ≤4 mm fragment). RESULTS: Median stone diameter was 1.7 cm (IQR 1.3-2.3). Median lithotripsy and total operative times were 8 min (IQR 5-16) and 22 min (IQR 20-35), respectively. Intraoperative SFR was 96%. Surgeons reported excellent instrument satisfaction (median Likert score 1/5) for vision, ease of use, and manoeuvrability within the pelvicalyceal system. Complications were rare: major (Clavien ≥ 3) occurred in 0.9% (n = 3, including colonic injury, pleural injury, sepsis. One case developed lower pole arteriorvenous fistula, managed by arterial angioembolization. At 30 days, SFR was 100%: Grade A (no fragments) in 47.9% (n = 157) and Grade B (≤ 4 mm fragment) in 52.1% (n = 171). Reintervention (ESWL) was needed in 1.2% (n = 4) within 3 months. Scope tip damage occurred in 0.6% (n = 2). CONCLUSION: The digital disposable nephroscope demonstrated excellent feasibility and safety in SM-PCNL, facilitating efficient stone clearance time (median 22 min), high SFR, minimal complications, and superior surgeon ergonomics. Its dual cystoscope-nephroscope functionality and plug-and-play design offer significant versatility, supporting its role in advancing minimally invasive PCNL.