Showing posts with label cystoscopy. Show all posts
Showing posts with label cystoscopy. Show all posts

Wednesday, September 5, 2018

FDA clears easy to use, low-cost Luminelle DTx Hysteroscopy/Cystoscopy system in the US


UVision360's, a Raleigh, N.C.-based company announced that its Luminelle DTx hysteroscopy system used for performing both hysteroscopy and cystoscopy won FDA clearance for sale in the US.

The Luminelle DTx Hysteroscopy System is simplified, easy to navigate, fully integrated hysteroscopy system designed for benefits for patients and physician alike.

It enables the physician to perform diagnostic and operative procedures in the office with 75% less investment as compared to traditional endoscopy tower systems. Patients can rip the benefits of faster procedural and recovery time along with cost savings.

The system features a two-part single-use protective sheath consisting of the introducer and 360° Rotating sheath. The introducer thoroughly covers the scope thereby protecting it against bodily fluid and reducing contamination to the minimum. It also separates the inflow and outflow channels to manage the irrigation fluids. The operative channel enables biopsies and polypectomies under direct visualization.


The 360° Rotating sheath facilitates ease of movements and 360° view of the uterine cavity. The flexible 2.0 mm scope is equipped with the latest CMOS micro-technology for a high resolution, high definition view of the inside of uterus and bladder to a depth of 45-55 mm. Specially designed visualization software comes with auto-adjusting lighting for more comfortable viewing of cavities.  The whole procedure can be monitored via HDMI or USB 3 for PC or Mac systems, making use of systems already existing in the office.

Dr. Amy Garcia, MD FACOG; Director – Center for Women's Surgery; Institute for Hysteroscopy Training, Albuquerque, NM explains, "Since the best technology is typically only available in the operating room, many physicians and patients opt to skip the hysteroscopy and either perform a blind biopsy or go straight to surgery, without taking a good look inside of the uterus. An in-office system that is easy to use prevents a blind biopsy and allows the physician to offer either a therapeutic diagnosis or a biopsy under visualization elevates the standard for uterine care."

Allison London Brown, CEO of UVision360 said in a news release, "Most operating room equipment is cost and space prohibitive for standard office use. We created an elegant and ergonomic system with visualization quality comparable to that of the OR, and that is comfortable for both physician and patient."

"Our system is a fully-integrated hysteroscopy/cystoscopy system with a value-based cost to provide better accessibility for the changing needs of today's GYN. The combined features lead to the potential for better care for women, earlier detection, and improved health outcomes," she further added.




Monday, December 7, 2015

Is routine cystoscopy to detect urinary tract injuries at gynecologic surgery feasible ?



Teeluckdharry et al. - Urinary Tract Injury at Benign Gynecologic Surgery and the Role of Cystoscopy: A Systematic Review and Meta-analysis.
Obstetrics & Gynecology, December 2015

This is a recent review and meta-analysis on role of routine use of cystoscopy in benign gynecological surgeries

Why this topic is important?

Injuries to the urinary tract, even if they occur relatively infrequently, can cause significant morbidity. Thus, intraoperative detection and recognition of urinary tract injuries remain very important for patients and gynecologists because they decrease morbidity and result in less litigation. Up to 75% of ureteric injuries are caused by gynecologic surgery and interestingly, most injuries occur during procedures for benign diseases.

What is the aim of the study?

The study aims to derive the rate of routine urinary tract injuries during benign gynecological surgeries and does routine use cystoscopy is a safeguard against them.

The subjects and the study design.

It is a Systematic review with pooled data from 79 studies between January 2004 to August 2014.


Interesting table in the study:

source:http://journals.lww.com/greenjournal/Fulltext/2015/12000/Urinary_Tract_Injury_at_Benign_Gynecologic_Surgery.7.aspx


Main outcome results:

The study got an adjusted ureteric injury rate of 0.3% and a bladder injury rate of 0.8%. The estimated postoperative ureteric injury detection rates per 1,000 surgeries were 1.6 without routine cystoscopy and 0.7 with routine cystoscopy. Postoperative bladder injury detection rates per 1,000 surgeries were 0.8 without routine cystoscopy and 1.0 with routine cystoscopy.
The study found that the proportion of ureteric and bladder injuries detected intraoperatively without routine cystoscopy is approximately 18% and 79%, respectively. However, when cystoscopy is performed, the proportion of ureteric or bladder injuries detected intraoperatively increases to approximately 95%.

What were the study strengths and weaknesses?
The study combines pooled data from a total of 79 studies but the the majority of studies were retrospective  which lowers postoperative injury detection rates.
What are the “practice essentials” learned from the study?
The study concludes that until more evidence is accumulated, the clinicians should learn the skills and maintain a low threshold for performing cystoscopy selectively in any cases in which there is suspicion of ureteric or bladder injury.

References: