The utility of flexible and navigable suction access sheath (FANS) in patients undergoing same session flexible ureteroscopy for bilateral renal calculi: a global prospective multicenter analysis by EAU endourology

• DOI: 10.1007/s00345-025-05477-9
• Publication Date: 2025-02-28T06:24:00Z
• Authors: Vineet Gauhar; Bhaskar Somani; Daniele Castellani; Khi Yung Fong; Nariman Gadzhiev; Satyendra Persaud; Saeed Bin Hamri; Chu Ann Chai; Azimdjon Tursunkulov; Yiloren Tanidir; Boyke Soebhali; Anil Shrestha; Deepak Ragoori; Mohamed Elshazly; Mehmet Ilker Gokce; Vigen Malkhasyan; Yasser Farahat; Thomas Herrmann; Olivier Traxer; Steffi Kar Kei Yuen
• Keywords: Ureteroscopy; Nephrology

Abstract Purpose To assess the 30-day stone-free rate and peri-operative outcomes of flexible ureteroscopy (FURS) with navigable suction ureteral access sheaths (FANS) in adults undergoing same-sitting bilateral retrograde intrarenal surgery (SSB-RIRS). Methods Prospectively data 115 adult patients kidney stone disease SSB-RIRS across 14 global centers between July 2023 March 2024 were analyzed. Patient demographics, characteristics operative recorded. A low-dose non contrast CT scan was performed at 30 days to clinical outcomes. Results Overall zero residual fragment(ZRF) 42.6%; unilateral ZRF 75.7%. Only two noted have fragments > 4 mm. 1.7% experienced Traxer-Thomas grade 1 ureteric injury which managed a stent for four weeks. No pelvicalyceal occured. Postoperative mean loin pain score 1.7 ± 1.0. None had sepsis nor required blood transfusion. 4.3% readmission within surgery. Multivariate analysis indicated longer total operation time correlated lower odds achieving 100% (ZRF) (OR 0.978, 95%CI = 0.959–0.994, p 0.013). Conclusion our knowledge, this is first multicenter study demonstrating use FANS can achieve low complication re-intervention rates. However, prolonged surgical may negatively impact The indications renal stones management FURS be expanded appropriate chosen patients.