The impact of single-use digital flexible cystoscope for double J removal on hospital costs and work organization: A multicentric evaluation

Oderda M., Amato A., de la Rosette J., Doizi S., Estrade V., Falcone M., ...More

Urologia Journal, vol.90, no.4, pp.670-677, 2023 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 90 Issue: 4
  • Publication Date: 2023
  • Doi Number: 10.1177/03915603231172543
  • Journal Name: Urologia Journal
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.670-677
  • Keywords: Flexible cystoscope, Isiris, cost, organization, single-use
  • Istanbul Medipol University Affiliated: Yes


Background: Isiris-α® is a single-use digital flexible cystoscope with an integrated grasper designed for double J (DJ) stent removal. Aim of this study was to conduct a multicentric evaluation of the costs and criticalities of stent removals performed with Isiris®-α in different hospitals and health systems, as compared to other DJ removal procedures. Methods: After gathering 10 institutions worldwide with experience on Isiris-α®, we performed an analysis of the reported costs of DJ removal with Isiris-α®, as compared to the traditional reusable equipment used in each institution. The cost evaluation included instrument purchase, Endoscopic Room (EnR)/ Operatory Room (OR) occupancy, medical staff, instrument disposal, maintenance, repairs, decontamination or sterilization of reusable devices. Results: The main factor affecting the costs of the procedure was OR/EnR occupancy. Decontamination and sterilization accounted for a less important part of total costs. Isiris-α® was more profitable in institutions where DJ removal is usually performed in the EnR/OR, allowing to transfer the procedure to outpatient clinic, with a significant cost saving and EnR/OR time saving to be allocated to other activities. In the only institution where DJ removal was already performed in outpatient clinics, there is a slight cost difference in favor of reusable instruments in high-volume institutions, given a sufficient number to guarantee the turnover. Conclusion: Isiris-α® leads to significant cost benefit in the institutions where DJ removal is routinely performed in EnR/OR, and brings significant improvement in organization, cost impact and turnover.