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Background: We aimed to define the published impact, efficacy, cost-effectiveness and precise role of the Isiris-α device: the world's first sterile, single-use grasper integrated flexible cystoscope (SUGIFC) for ureteral stent removal., Methods: After PROSPERO registration (CRD42021228755), the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were utilized. The search terms "Grasper Integrated Flexible Cystoscope," and "Isiris," within the following databases: PubMed, Scopus, Cochrane Library, Web of Science and EMBASE were searched., Results: In this review, a cumulative total experience (10 publications) included 970 "SUGIFC" procedures (755 patients). However, only 366/970 procedures were actually used for "ureteral stent removal," with the remainder being surveillance cystoscopy only (603/970) or foreign body retrieval (1/970). Procedure-related and device failures in planned "removal of ureteral stents," was reported in 8/366 (346 patients) and 1/366 (346 patients), respectively. The cost-benefit utilizing the SUGIFC device is advantageous compared to "in-theatre" stent removals and favours less busy centres where maintenance, repair and replacement costs are more relevant. Other listed benefits include shorter stent indwelling times, shorter procedure duration, lower rates of bacteriuria and urinary tract infections, fewer emergency department visits and lower readmission rates. Technical limitations include the absence of an independent working channel, a narrower visual field and the lack of image universality since the monitor is device-specific., Conclusion: The SUGIFC device needs to be outweighed against local costs and individual health systems. Its application in ambulatory ureteral stent removal may become significant due to the accessibility and convenience that it offers the attending urologist., (© 2021 Royal Australasian College of Surgeons.)

Background: Ureteral stent insertion and subsequent removal remains one of the most common procedures performed in endourology. We aimed to evaluate a novel, one‐step method, permitting simultaneous stent removal and guidewire passage using a self‐constructed suture snare via standard cystoscopy. This method should be used prior to ureteroscopy, in cases of minimal stent encrustation and peri‐ureteral mucosal oedema, where identification and subsequent cannulation of the ureteral orifice may be a challenge. Methods: A self‐constructed suture snare is constructed using an open‐ended ureteral catheter to facilitate this novel 'Switch' technique. Operative duration, cost feasibility and potential complications with this novel method were assessed in patients with an indwelling stent duration above 100 days. Results: Age inclusion in this study ranged from 21 to 35 years, with kidney, ureter and bladder scores below 6, in the five patients assessed. Previous ureteral stent indwelling time ranged from 106 to 315 days. Reasons for (pre‐stented) ureteroscopy were mostly stone related. The overall recorded procedure time for the Switch technique was successfully performed in less than 96 s (range 68–95 s) in all cases within this series. No procedure‐related complications were reported. Conclusion: Utilizing the suture snare, the novel Switch technique was successfully performed in all cases assessed. This method is both time and cost feasible and could be easily utilized in resource‐limited areas, regional centres or in cases where a stent grasper is not available, may have malfunctioned or cannot adequately approximate due to distal ureteral stent encrustation. [ABSTRACT FROM AUTHOR]