Advancing kidney stone management: A technical and commercial review of intraoperative medical device
Coughlan, Lee-Ann
Coughlan, Lee-Ann
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Identifiers
https://hdl.handle.net/10379/18200
https://doi.org/10.13025/18045
https://doi.org/10.13025/18045
Repository DOI
Publication Date
2024-06-07
Type
master thesis
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Abstract
The prevalence of kidney stones is increasing due to poor diet, hydration, and potentially rising global temperatures from climate change. Concurrently, the number of urologists is declining, necessitating innovative solutions to meet growing demand and reduce the risk of burnout among urologists.
The intraoperative treatment of kidney stones, particularly ureteroscopy, has seen limited innovation, and existing devices do not ensure complete extraction of kidney stone dust or fragments post-lithotripsy. Incomplete removal of kidney stones heightens the risk of recurrence, requiring additional treatment. Enhancing the "stone free rate" is critical, as higher stone free rates are linked to better patient outcomes. However, the definition of stone free rate remains inconsistent among urologists and researchers.
Recent advancements in the aspiration of kidney stone dust and alternative lithotripsy methods indicate a strong interest in improving procedures, yet these innovations fail to achieve complete dust and fragment removal.
Additionally, longer procedure times are associated with a higher risk of urosepsis, a significant mortality risk for what is typically an elective procedure. Research observations indicate that much of the time in ureteroscopy is spent "fishing" for fragments post-lithotripsy.
A method that fully removes all stone dust and fragments could standardize treatment and reduce inconsistencies. Improving the efficiency and effectiveness of stone removal is expected to enhance patient outcomes and throughput. Further research is necessary to validate the hypothesis that easier and complete removal of stones post-lithotripsy will improve patient outcomes and reduce procedure time, thereby increasing the number of patients treated by a declining number of urologists.
This study comparatively assesses design concepts for such a method to meet the defined criteria of an ideal solution, completes an initial assessment of intellectual property, and outlines a proposal for the pathway to implementation.
There is a substantial market for improved kidney stone treatment, yet little evidence suggests existing intellectual property for a device capable of fully addressing this need. Therefore, there is opportunity for innovation to prevent the dispersal of kidney stones for total extraction during ureteroscopy to improve stone free rate.
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Publisher
University of Galway
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Attribution-NonCommercial-NoDerivatives 4.0 International