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The Vortex Intelligent Stone Optimized Removal (VISOR) system has recently been introduced as an alternative to FANS, featuring an integrated irrigation-suction dual-channel and IRP control design. This study aimed to evaluate the efficacy of VISOR system in comparison with FANS in vitro.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>3D-printed renal models were used, and 3\u00a0g of human calcium phosphate stones were treated via VISOR system versus FANS ureteroscopy. All procedures were performed by a single experienced urologist with a holmium laser. Primary outcome was stone clearance efficiency (SCE), calculated as: SCE (%) = [(Initial stone mass\u2009\u2212\u2009Residual stone mass) \/ Initial stone mass] \u00d7 100%. Secondary outcomes included operative time, total laser energy use, residual stone mass and total stone mass removed. Accuracy of IRP measurements was also tested for the VISOR system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The VISOR system demonstrated comparable SCE to FANS (95.1\u2009\u00b1\u20090.6% vs. 94.8\u2009\u00b1\u20090.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.78). The mean operative time in the VISOR group was significantly lower by 26.2% compared with FANS (55.1\u2009\u00b1\u20092.2 vs. 74.7\u2009\u00b1\u20092.3\u00a0min,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). We found no difference in total laser energy use (33.6\u2009\u00b1\u20091.4 vs. 33.3\u2009\u00b1\u20095.3\u00a0kJ,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.96), residual stone mass (0.15\u2009\u00b1\u20090.03 vs. 0.15\u2009\u00b1\u20090.04\u00a0g,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.99) and total removed stone mass (1.86\u2009\u00b1\u20090.13 vs. 1.81\u2009\u00b1\u20090.12\u00a0g,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.79). The VISOR system\u2019s pressure sensor showed good correlation with an external reference pressure meter (Spearman\n                      <jats:italic>R<\/jats:italic>\n                      \u2009=\u20090.99,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Based on these in vitro findings, the VISOR integrated dual-channel system demonstrated SCE comparable to FANS, with significantly shorter operative time and reliable real-time IRP control. These results suggest that the VISOR system represents a promising candidate for further clinical evaluation; whether these performance advantages translate to improved patient outcomes in vivo requires confirmation in prospective clinical studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00345-026-06778-3","type":"journal-article","created":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:31:38Z","timestamp":1789659098000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["In vitro performance of the Vortex Intelligent Stone Optimized Removal (VISOR) system versus the flexible and navigable suction ureteral access sheath (FANS)\u00a0on stone clearance efficiency and intrarenal pressure control"],"prefix":"10.1007","volume":"44","author":[{"given":"Wenjun","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Fang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia-Lun","family":"Kwok","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baiyang","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steffi Kar Kei","family":"Yuen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet","family":"Gauhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1065-5011","authenticated-orcid":false,"given":"Bohan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"6778_CR1","doi-asserted-by":"publisher","first-page":"224","DOI":"10.1038\/s41581-021-00513-4","volume":"18","author":"P Singh","year":"2022","unstructured":"Singh P, Harris PC, Sas DJ, Lieske JC (2022) The genetics of kidney stone disease and nephrocalcinosis. 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