Objective To evluate the efficacy and safety of tip-flexible vacuum-assisted ureteral access sheath in flexible ureteroscopic laser lithotripsy.Methods Clinical data of 86 patients underwent flexible ureteroscopic laser lithotripsy between April 2021 and January 2022 were reviewed retrospectively.All the patients were pre-stented 2 weeks prior to lithotripsy procedure.The flexible ureteroscopic laser lithotripsy procedures were performed with a novel tip-flexible vacuum-assisted ureteral access sheath.There were 55 males and 31 females in our case series,with age ranged 19-85 years old.The mean calculi size was 16.6 mm(range 9.0 to 42.0 mm).Twenty-seven calculus located in the upper ureter and 59 calculus located in the kidney.Thirty-nine cases were multiple calculus,while 47 were single.Results Eighty-five cases were finished uneventfully,while 1 procedure failed because of ureter stricture and completed after another 2 weeks'stenting.The mean operative time was 65.2min(range 8 to 183mins).Two cases experienced post-operative fever(2.3%).The stone-free rate was 95.3%1 month post operation.Eleven cases were not stented post laser lithotripsy procedure.No patients suffered from renal colic,hematoma and steinstrasse post-operatively.Conclusion Tip-flexible vacuum-assisted ureteral can lower renal pelvis pressure(RPP),maintain clear intra-operative vision,reduce complication rate and increase stone free rate.It is safe and effective while implicated in flexible ureteroscopic laser lithotripsy.vision,reduce complication rate and increase stone free rate.It is safe and effective while implicated in flexible ureteroscopic laser lithotripsy.
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