{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T05:55:55Z","timestamp":1792130155360,"version":"4.4.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T00:00:00Z","timestamp":1692230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["No. 82060467"],"award-info":[{"award-number":["No. 82060467"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013064","name":"Key Research and Development Program of Jiangxi Province","doi-asserted-by":"publisher","award":["20171ACB20029"],"award-info":[{"award-number":["20171ACB20029"]}],"id":[{"id":"10.13039\/501100013064","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Urolithiasis"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    This study aims to explore the optimal location of flexible ureteral access sheath (f-UAS) in retrograde intrarenal lithotripsy (RIRS). RIRS model was built by AutoCAD 2011 software, and imported COMSOL 5.6 software to computer simulation. An RIRS model was constructed in vitro to analyze the distribution pattern of stone fragments and compare the weight of stone fragments carried out by the irrigation fluid when the f-UAS is in different positions. Computer simulation showed that the highest flow of irrigation fluid was in the channel of flexible ureteroscopy (f-URS) and in the lumen of f-UAS. From the f-URS to the renal collection system and then to the f-UAS, the velocity of irrigation fluid changes gradually from high-flow to low-flow and then to high-flow. When the f-URS and the f-UAS are at the same level, the irrigation fluid is always at a state of high flow during the process from f-URS to f-UAS. When the f-URS and the f-UAS are at the same level, it can increase the local intrarenal pressure (IRP) at the front of f-URS. The stone fragments are mainly sediment in the low-flow region of irrigation fluid. More stone fragments could follow the irrigation fluid out of the body when the tip of f-URS and the tip of f-UAS are at the same level (\n                    <jats:italic>P<\/jats:italic>\n                    \u2009&lt;\u20090.001). The f-UAS should be brought closer to the stone in RIRS. And more stone fragments can be taken out of the body by the effect of irrigation fluid.\n                  <\/jats:p>","DOI":"10.1007\/s00240-023-01469-9","type":"journal-article","created":{"date-parts":[[2023,8,17]],"date-time":"2023-08-17T12:02:21Z","timestamp":1692273741000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Optimal placement of flexible ureteral access sheath in retrograde intrarenal surgery"],"prefix":"10.1007","volume":"51","author":[{"given":"Yujun","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofeng","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heng","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Deng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luyao","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gongxian","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaochen","family":"Zhou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,8,17]]},"reference":[{"issue":"7","key":"1469_CR1","doi-asserted-by":"publisher","first-page":"2733","DOI":"10.1007\/s00345-020-03459-7","volume":"39","author":"M Komeya","year":"2021","unstructured":"Komeya M, Odaka H, Watanabe T et al (2021) Gap between UAS and ureteroscope predicts renal stone-free rate after flexible ureteroscopy with the fragmentation technique. World J Urol 39(7):2733\u20132739","journal-title":"World J Urol"},{"issue":"2","key":"1469_CR2","doi-asserted-by":"publisher","first-page":"393","DOI":"10.1007\/s00345-018-2510-5","volume":"37","author":"S Tonyali","year":"2019","unstructured":"Tonyali S (2019) Suctioning ureteral access sheath use in flexible ureteroscopy might decrease operation time and prevent infectious complications. World J Urol 37(2):393\u2013394","journal-title":"World J Urol"},{"issue":"4","key":"1469_CR3","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1016\/S0090-4295(02)02440-8","volume":"61","author":"J Rehman","year":"2003","unstructured":"Rehman J, Monga M, Landman J et al (2003) Characterization of intrapelvic pressure during ureteropyeloscopy with ureteral access sheaths. Urology 61(4):713\u2013718","journal-title":"Urology"},{"issue":"9","key":"1469_CR4","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1089\/end.2019.0317","volume":"33","author":"Y Noureldin","year":"2019","unstructured":"Noureldin Y, Kallidonis P, Ntasiotis P et al (2019) In Vivo the effect of irrigation power and ureteral access sheath diameter on the maximal intra-pelvic pressure during ureteroscopy: experimental study in a live anesthetized pig. J Endourol 33(9):725\u2013729","journal-title":"J Endourol"},{"issue":"5","key":"1469_CR5","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1016\/j.euf.2021.10.011","volume":"8","author":"G Zeng","year":"2022","unstructured":"Zeng G, Zhao Z, Mazzon G et al (2022) European association of urology section of urolithiasis and international alliance of urolithiasis joint consensus on retrograde intrarenal surgery for the management of renal stones. Eur Urol Focus 8(5):1461\u20131468","journal-title":"Eur Urol Focus"},{"issue":"1","key":"1469_CR6","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.euf.2021.01.010","volume":"7","author":"S Doizi","year":"2021","unstructured":"Doizi S (2021) Intrarenal pressure: what is acceptable for flexible ureteroscopy and percutaneous nephrolithotomy? Eur Urol Focus 7(1):31\u201333","journal-title":"Eur Urol Focus"},{"issue":"11","key":"1469_CR7","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0208209","volume":"13","author":"A Oratis","year":"2018","unstructured":"Oratis A, Subasic J, Hernandez N et al (2018) A simple fluid dynamic model of renal pelvis pressures during ureteroscopic kidney stone treatment. PLoS ONE 13(11):e0208209","journal-title":"PLoS ONE"},{"issue":"4","key":"1469_CR8","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1007\/s11934-017-0677-8","volume":"18","author":"J Santiago","year":"2017","unstructured":"Santiago J, Hollander A, Soni S et al (2017) To dust or not to dust: a systematic review of ureteroscopic laser lithotripsy techniques. Curr Urol Rep 18(4):32","journal-title":"Curr Urol Rep"},{"issue":"4","key":"1469_CR9","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1007\/s00240-018-1076-4","volume":"47","author":"A Pietropaolo","year":"2019","unstructured":"Pietropaolo A, Jones P, Whitehurst L et al (2019) Role of \u2018dusting and pop-dusting\u2019 using a high-powered (100 W) laser machine in the treatment of large stones (\u2265 15 mm): prospective outcomes over 16 months. Urolithiasis 47(4):391\u2013394","journal-title":"Urolithiasis"},{"issue":"1","key":"1469_CR10","first-page":"1","volume":"16","author":"G Atis","year":"2019","unstructured":"Atis G, Pelit E, Culpan M et al (2019) The fate of residual fragments after retrograde intrarenal surgery in long-term follow-up. Urol J 16(1):1\u20135","journal-title":"Urol J"},{"issue":"2","key":"1469_CR11","doi-asserted-by":"publisher","first-page":"129","DOI":"10.1097\/MOU.0000000000000571","volume":"29","author":"R Suarez-Ibarrola","year":"2019","unstructured":"Suarez-Ibarrola R, Hein S, Miernik A (2019) Residual stone fragments: clinical implications and technological innovations. Curr Opin Urol 29(2):129\u2013134","journal-title":"Curr Opin Urol"},{"issue":"5","key":"1469_CR12","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1111\/bju.15873","volume":"130","author":"Y Chen","year":"2022","unstructured":"Chen Y, Zheng L, Lin L et al (2022) A novel flexible vacuum-assisted ureteric access sheath in retrograde intrarenal surgery. BJU Int 130(5):586\u2013588","journal-title":"BJU Int"},{"issue":"9","key":"1469_CR13","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1089\/end.2022.0004","volume":"36","author":"Y Chen","year":"2022","unstructured":"Chen Y, Li C, Gao L et al (2022) Novel flexible vacuum-assisted ureteral access sheath can actively control intrarenal pressure and obtain a complete stone-free status. J Endourol 36(9):1143\u20131148","journal-title":"J Endourol"},{"issue":"5","key":"1469_CR14","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1111\/bju.15593","volume":"129","author":"J Lazarus","year":"2022","unstructured":"Lazarus J, Kaestner L (2022) Novel syphon ureteral access sheath has potential to improve renal pressures and irrigant flow. BJU Int 129(5):642\u2013647","journal-title":"BJU Int"},{"issue":"5","key":"1469_CR15","doi-asserted-by":"publisher","first-page":"921","DOI":"10.1007\/s00345-018-2455-8","volume":"37","author":"Z Zhu","year":"2019","unstructured":"Zhu Z, Cui Y, Zeng F et al (2019) Comparison of suctioning and traditional ureteral access sheath during flexible ureteroscopy in the treatment of renal stones. World J Urol 37(5):921\u2013929","journal-title":"World J Urol"},{"issue":"1","key":"1469_CR16","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1007\/s00240-023-01430-w","volume":"51","author":"B Song","year":"2023","unstructured":"Song B, Jin D, Cheng Y et al (2023) What is the appropriate gravel size during ureteroscopy lithotripsy? An in vitro evaluation. Urolithiasis 51(1):52","journal-title":"Urolithiasis"},{"issue":"2","key":"1469_CR17","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1061\/(ASCE)0733-9429(2003)129:2(110)","volume":"129","author":"FC Wu","year":"2003","unstructured":"Wu FC, Chou YJ (2003) Rolling and lifting probabilities for sediment entrainment. J Hydraul Eng 129(2):110\u2013119","journal-title":"J Hydraul Eng"},{"issue":"1","key":"1469_CR18","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1007\/s00240-022-01377-4","volume":"51","author":"G Faria-Costa","year":"2022","unstructured":"Faria-Costa G, Tsaturyan A, Peteinaris A et al (2022) Determinants of outflow rate through the ureteral access sheath during flexible ureteroscopy: an experimental in vivo study in an anesthetized porcine model. Urolithiasis 51(1):18","journal-title":"Urolithiasis"},{"issue":"5","key":"1469_CR19","doi-asserted-by":"publisher","first-page":"717","DOI":"10.1007\/s00345-015-1682-5","volume":"34","author":"R Mager","year":"2016","unstructured":"Mager R, Balzereit C, Gust K et al (2016) The hydrodynamic basis of the vacuum cleaner effect in continuous-flow PCNL instruments: an empiric approach and mathematical model. World J Urol 34(5):717\u2013724","journal-title":"World J Urol"},{"issue":"11","key":"1469_CR20","doi-asserted-by":"publisher","first-page":"1847","DOI":"10.1007\/s00345-015-1541-4","volume":"33","author":"A Nicklas","year":"2015","unstructured":"Nicklas A, Schilling D, Bader M et al (2015) The vacuum cleaner effect in minimally invasive percutaneous nephrolitholapaxy. World J Urol 33(11):1847\u20131853","journal-title":"World J Urol"},{"issue":"5","key":"1469_CR21","doi-asserted-by":"publisher","first-page":"735","DOI":"10.1111\/bju.13955","volume":"120","author":"G Zeng","year":"2017","unstructured":"Zeng G, Zhu W, Liu Y et al (2017) The new generation super-mini percutaneous nephrolithotomy (SMP) system: a step-by-step guide. BJU Int 120(5):735\u2013738","journal-title":"BJU Int"},{"issue":"3","key":"1469_CR22","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1097\/JU.0000000000001836","volume":"206","author":"E Brain","year":"2021","unstructured":"Brain E, Geraghty R, Lovegrove C et al (2021) Natural history of post-treatment kidney stone fragments: a systematic review and meta-analysis. J Urol 206(3):526\u2013538","journal-title":"J Urol"},{"issue":"4","key":"1469_CR23","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1177\/0391560319860654","volume":"86","author":"D Prezioso","year":"2019","unstructured":"Prezioso D, Barone B, Di Domenico D et al (2019) Stone residual fragments: a thorny problem. Urologia 86(4):169\u2013176","journal-title":"Urologia"},{"issue":"4","key":"1469_CR24","doi-asserted-by":"publisher","first-page":"229","DOI":"10.4111\/icu.2016.57.4.229","volume":"57","author":"D Han","year":"2016","unstructured":"Han D, Jeon S (2016) Stone-breaking and retrieval strategy during retrograde intrarenal surgery. Investig and clin urol 57(4):229\u2013230","journal-title":"Investig and clin urol"},{"issue":"5","key":"1469_CR25","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1038\/nrurol.2015.74","volume":"12","author":"K Ghani","year":"2015","unstructured":"Ghani K, Wolf J, Wolf J (2015) What is the stone-free rate following flexible ureteroscopy for kidney stones? Nat Rev Urol 12(5):281\u2013288","journal-title":"Nat Rev Urol"}],"container-title":["Urolithiasis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00240-023-01469-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00240-023-01469-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00240-023-01469-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,27]],"date-time":"2023-11-27T07:15:24Z","timestamp":1701069324000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00240-023-01469-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,8,17]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1469"],"URL":"https:\/\/doi.org\/10.1007\/s00240-023-01469-9","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-2794819\/v1","asserted-by":"object"}]},"ISSN":["2194-7236"],"issn-type":[{"value":"2194-7236","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,8,17]]},"assertion":[{"value":"9 April 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 July 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 August 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The author declares that they have no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}],"article-number":"106"}}