scholarly journals Cost Analysis and Service Delivery on Using Isiris α™ To Remove Ureteric Stents

2018 ◽  
Vol 1 (1) ◽  
pp. e3-e16 ◽  
Author(s):  
Yih Chyn Phan ◽  
Jonathan Cobley ◽  
Wasim Mahmalji
Keyword(s):  
Medical Association ◽  
Cost Analysis ◽  
Ureteric Stent ◽  
Flexible Cystoscopy ◽  
Stent Removal ◽  
Ureteric Stents ◽  
Flexible Cystoscope ◽  
Single Use ◽  
College Of Nursing ◽  
The Cost

Introduction Isiris α™ (Coloplast®) is an innovative single-use disposable flexible cystoscope with an integrated ureteric stent grasper designed specifically to remove ureteric stents. It allows clinicians to remove ureteric stents easily on the wards or in clinics without the need of arranging a routine and dedicated flexible cystoscopy appointment for patients. We evaluated Isiris α’s practical use and cost analysis against traditional reusable endoscopes. Method We compared the cost of removing ureteric stents using Isiris α™ in 10 patients prospectively versus traditional flexible cystoscopes in 10 patients retrospectively. The costs of the equipment, medications, reprocess machines, and utility costs were consulted from the relevant departments and companies. As for labour cost, we have sourced British Medical Association (BMA) and Royal College of Nursing (RCN) websites. Results From our study, it costs £260.65 and £123.41 on average to remove a ureteric stent using Isiris α™ and traditional flexible cystoscope respectively (p<0.001). Stent removal in the endoscopy department was delayed in 60% of patients, on average 6.4 days, compared to 0% of patients using Isiris α™ (p = 0.048). Conclusion Although Isiris α™ is shown to be a more expensive option to remove ureteric stents based on our analysis, it still provides clinicians flexibility and ease in removing ureteric stents in the outpatient clinic, reducing the pressure and demand for dedicated flexible cystoscopy slots in the endoscopy department.

Prospective trial of single-use, flexible cystoscope for ureteric double-J stent removal: Cost and utility analysis

2019 ◽  
Vol 13 (2) ◽  
pp. 160-163 ◽  
Author(s):  
Peter Donato ◽  
Matthew Honore ◽  
Tafadzwa Zana ◽  
Morgan Pokorny ◽  
William Bowes ◽  
...  
Keyword(s):  
Prospective Trial ◽  
Cost Benefit ◽  
Level Of Evidence ◽  
Stent Removal ◽  
Repair Costs ◽  
Flexible Cystoscope ◽  
Single Use ◽  
The Cost ◽  
Procedural Outcomes ◽  
The Impact

Objective: The objective of this study is to evaluate the costs and benefits of Isiris (Coloplast, Denmark), a mobile, single-use, flexible cystoscope with a built-in stent grasper. Methods: A prospectively collected database was reviewed to define procedural outcomes for Isiris ureteric stent removal. Variables assessed included stent duration and location of removal. A cost assessment was performed evaluating the impact on costs, funding and facility use. Results: Seventy-five procedures were performed using Isiris between April and September 2017. There were no complications. Two procedures failed because of encrustation and poor visibility secondary to haematuria. The mean (SD), median (interquartile range) and range of delay were 2.1 (0–5.3), 0 (0–2) and 0–40 days, respectively. Only one patient was delayed more than two weeks; this occurred because he was placed on a theatre waiting list, which resulted in the 40-day delay. Overall, the cost benefit for our department with the introduction of the Isiris system has been a surplus of $104,434, with an extra 65 elective spaces free for diagnostic flexible cystoscopy cases. Conclusion: Isiris flexible stent removal offers our patients a rapid stent-removal service with low rates of removal delay. Savings have been made in scope repair costs, sterilisation and scope maintenance, as well as optimisation of theatre and procedure room space. Level of evidence: 1c

Isiris™ for Ureteric Stent Removal in Renal Transplantation: An Initial Single-Centre Experience of 150 Cases

2021 ◽  
pp. 155335062110072
Author(s):  
Daniel T. Doherty ◽  
Zia Moinuddin ◽  
Ben R. Grey ◽  
David van Dellen
Keyword(s):  
Outpatient Clinic ◽  
Healthcare Providers ◽  
Operating Theatre ◽  
Stent Insertion ◽  
Environmental Implications ◽  
Ureteric Stent ◽  
Stent Removal ◽  
Ureteric Stents ◽  
Urological Complications ◽  
Single Use

Background. Ureteric stent insertion is performed at the time of renal transplant to minimise the risk of post-operative urological complications, including anastomotic leak and ureteric stenosis or obstruction. Transplant ureteric stent removal (TUSR) has historically been performed via flexible cystoscopy, predominantly in a theatre setting. Isiris™ is a single-use cystoscope with integrated grasper designed for removal of ureteric stents. We report our initial experience. Methods. A retrospective analysis of a contemporaneously maintained database was performed with review of case notes from October 2017 to September 2018. TUSR was performed by surgical middle grades with a single nurse assistant. Results. One hundred and fifty ureteric stents were removed in transplant recipients (mean age 50.2 years, SD ± 15.2; 61.3% male). 91.3% ( n = 137) of cases were performed in the outpatient clinic. Median time to TUSR was 42 days (IQR 30-42). 147 attempts at removal were successful. One urinary tract infection (UTI) was reported following TUSR. Use of the Isiris™ for TUSR corresponds to a £63,480 saving in this cohort compared to conventional practice. This value is conservative and does not include income that has been gained from the reallocation of operating theatre capacity. Conclusion. Isiris™ can safely be employed for the timely performance of non-complicated TUSR. Isiris™ releases this procedure from the confines of the operating theatre to the outpatient clinic. This reduces the resource burden for healthcare providers and may result in improved patient satisfaction. The environmental implications of disposable healthcare equipment require consideration. Evaluation of Isiris™ TUSR for encrustation is required.

scholarly journals The First UK Experience with Single-use Disposable Flexible Cystoscopes: An In-depth Cost Analysis, Service Delivery and Patient Satisfaction Rate with Ambu® aScope™ 4 Cysto

2021 ◽  
Vol 4 (1) ◽  
pp. e29-e44
Author(s):  
Anton Wong ◽  
YC Phan ◽  
Helen Thursby ◽  
Wasim Mahmalji
Keyword(s):  
Patient Satisfaction ◽  
Cost Analysis ◽  
Statistical Significance ◽  
Patient Survey ◽  
Emergency Setting ◽  
Flexible Cystoscopy ◽  
Single Use ◽  
Cost Efficient ◽  
The Uk ◽  
The Cost

Background and ObjectiveAmbu® aScope™ 4 Cysto is a single-use disposable flexible cystoscope that allows clinicians to perform the procedure at any time and any place. It simplifies workflow, frees up resources and allows clinicians to treat more patients. Our trust became the first in the UK and Europe to utilise these cystoscopes. An in-depth evaluation was performed to test its practicality, cost analysis and patient satisfaction against traditional reusable flexible cystoscopes. Material and MethodsWe compared the cost of using Ambu® aScope™ 4 Cysto to perform flexible cystoscopies in 20 patients prospectively against traditional flexible cystoscopes in 20 patients retrospectively. The cost of the equip-ment, reprocessing, cleaning supplies and maintenance were consulted from relevant departments and companies. All prospective patients were also given a patient satisfaction questionnaire to complete. An unpaired t-test was used to analyse the data. ResultsOur study revealed that it costs £135.23 and £166.33 on average to perform a flexible cystoscopy using Ambu® aScope™ 4 Cysto and the traditional flexible cystoscopes, respectively. Our patient survey revealed that there was a statistical significance between the patient experience using the single-use disposable scopes compared with the traditional reusable flexible cystoscopes (P = 0.0455). Further, 95% of patients also preferred a single-use disposable cystoscope over traditional reusable ones, given the option. ConclusionSingle-use disposable flexible cystoscopes are a safe and cost-efficient method of performing the procedure. It is portable and proves to be a simple, efficient and practical way of performing a flexible cystoscopy in an inpatient, outpatient, or emergency setting.

Single-Use Grasper Integrated Flexible Cystoscope for Stent Removal: A Micro-Costing Analysis-Based Comparison

2020 ◽  
Vol 34 (8) ◽  
pp. 816-820
Author(s):  
Sarah C. Beebe ◽  
Lawrence C. Jenkins ◽  
Tasha Posid ◽  
Bodo E. Knudsen ◽  
Michael W. Sourial
Keyword(s):  
Stent Removal ◽  
Flexible Cystoscope ◽  
Single Use ◽  
Costing Analysis

scholarly journals MP55-05 IMPACT OF DOUBLE-J STENT REMOVAL WITH A SINGLE USE CYSTOSCOPE DEDICATED TO THIS PROCEDURE: A COST ANALYSIS

2018 ◽  
Vol 199 (4S) ◽  
Author(s):  
Steeve DOIZI ◽  
Maria RODRIGUEZ-MONSALVE ◽  
Vincent DE CONINCK ◽  
Etienne KELLER ◽  
Emmanuelle GRANIER ◽  
...  
Keyword(s):  
Cost Analysis ◽  
Stent Removal ◽  
Double J Stent ◽  
Single Use

A review of techniques for difficult catheterisation and their costs

2021 ◽  
pp. 205141582110391
Author(s):  
Rion Healy ◽  
James Edward Dyer
Keyword(s):  
Supply Chain ◽  
Cost Analysis ◽  
Literature Search ◽  
Cost Effective ◽  
Evidence Based ◽  
Level Of Evidence ◽  
Flexible Cystoscopy ◽  
Cost Implications ◽  
The Cost

Objective: Awareness of departmental expenditure gives surgeons the ability to make cost-effective decisions. We reviewed the available techniques for difficult catheterisation and assessed the cost of each method. Methods: A literature search was undertaken using EMBASE and Medline databases. Seven techniques for difficult catheterisation were identified, and a cost analysis was performed. All items required for a technique were costed per unit, including VAT, and can be referenced to the NHS supply chain. Results: Techniques were divided into three broad categories: simple urethral techniques – increased lubrication with different catheter sizes (£5.05) or types (£8.83 Tiemann tip, £10.65 Coude tip); complex urethral techniques – blind hydrophilic guidewire (£27.31), S-dilators (£244.62) and flexible cystoscopy (£38.78); and percutaneous techniques – suprapubic catheterisation (£117.38). Conclusion: This paper demonstrates a progression in cost and specialist input required when moving from simple urethral techniques to complex and percutaneous techniques. It is clear that clinicians should consider these cost implications and exhaust all simple techniques before moving to the more complex options. We would advocate the use of a national evidence-based difficult catheter algorithm to guide management based on both effectiveness and cost. Level of evidence: Not applicable.

Cost-effectiveness analysis of a single-use digital flexible cystoscope for double J removal

2019 ◽  
Vol 87 (1) ◽  
pp. 29-34 ◽  
Author(s):  
Marco Oderda ◽  
Jacopo Antolini ◽  
Marco Falcone ◽  
Sergio Lacquaniti ◽  
Giuseppe Fasolis
Keyword(s):  
Cost Effectiveness ◽  
Cost Effectiveness Analysis ◽  
The Novel ◽  
Special Equipment ◽  
Stent Removal ◽  
Effectiveness Analysis ◽  
Flexible Cystoscope ◽  
Single Use ◽  
Mean Cost ◽  
Room Time

Introduction and objective: The novel single-use digital flexible cystoscope Isiris™ has been developed to perform in-office JJ stent removal, without the need of special equipment nor limitations linked to the disinfection of a reusable device. The aim of our study was to perform a cost-effectiveness analysis of Isiris™ in our institution. Patients and methods: A total of 127 consecutive patients undergoing in-office stent removal with Isiris™ were prospectively included in study. After each procedure, the urologist filled a questionnaire specifically developed to evaluate the efficiency of the device and the invasiveness of the procedure. We performed a cost analysis of the main variables involved in JJ removal using Isiris™ versus the traditional Storz™ reusable flexible cystoscope used for all our previous patients. Results: The procedure was successful in all cases except for one, where the device did not work due to the failure of the grasper and had to be replaced. Overall, the performance of Isiris™ was judged by the physician “very good” and “good” in 90.6% of the cases. Both median pain and invasiveness felt by the patient were 0 (range = 0–8). The mean cost of procedure was estimated at €361 for in-office stent removal with Isiris™, and €1.126.8 for stent removal in operatory room with a reusable flexible cystoscope. Considering the 127 procedures performed in office, 64 h of operatory room time was saved. Conclusion: In institutions where JJ removal is performed in the operatory room, Isiris™ leads to a significant advantage in terms of money saved per procedure, operatory room time gained and patient satisfaction.

scholarly journals A survey of Canadian renal transplant surgeons: Use of ureteric stents and technique of the ureteroneocystotomy

2018 ◽  
Vol 12 (12) ◽  
Author(s):  
Luke F. Reynolds ◽  
Tad Kroczak ◽  
R. John Honey ◽  
Kenneth T. Pace ◽  
Jason Y. Lee ◽  
...  
Keyword(s):  
Renal Transplant ◽  
Dwell Time ◽  
Online Survey ◽  
Primary Outcome ◽  
Prophylactic Antibiotics ◽  
Ureteric Stent ◽  
Stent Removal ◽  
Ureteric Stenting ◽  
Ureteric Stents

Introduction: The role of ureteric stenting in renal transplant has been well-demonstrated. The goal of this survey was to determine the use of ureteric stents by Canadian transplant surgeons and how the ureteroneocystotomy and followup is performed. Methods: An online survey was sent to the 40 surgeon members of the Canadian Society of Transplantation. The primary outcome was the rate of ureteric stent use at the time of renal transplantation. The secondary outcomes were the ureteric stent dwell time, use and type of prophylactic antibiotics, and the use of routine post-transplant ultrasonography. Results: All respondents (25) used ureteric stent routinely and 92% remove the stent between four and six weeks postoperatively. Prophylactic antibiotics were used 64% of the time for ureteric stent removal. The majority of surgeons do not routinely perform a post-stent removal ultrasound. Fifty-six percent of respondents perform a refluxing anastomosis. Conclusions: Ureteric stents are routinely used in renal transplant in Canada. Areas for improvement and topics of debate identified from this survey are the need for peri-stent removal antibiotics, the role of post-stent removal ultrasound, the duration of stent dwell time, and the need for a non-refluxing ureteroneocystotomy.

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