{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T01:02:42Z","timestamp":1780794162704,"version":"3.54.1"},"reference-count":21,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T00:00:00Z","timestamp":1758844800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100008497","name":"Boston Scientific Corporation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008497","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>\n                      To study the effects of ureteroscope diameter, \u2018flexible and navigable suction\u2019 access sheaths (FANS) diameter, and irrigation pressure on intrarenal pressure (IRP) and irrigation fluid flow rates in\n                      <jats:italic>ex vivo<\/jats:italic>\n                      porcine kidneys; these benchtop data were compared against mathematical modelling results.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>\n                      Fresh\n                      <jats:italic>ex vivo<\/jats:italic>\n                      porcine kidneys and ureters were used. The tip of an 11\/13\u2010 or 10\/12\u2010F ClearPetra\n                      <jats:italic>\u00ae<\/jats:italic>\n                      FANS was placed within the renal pelvis. Either a 9.5\u2010F Boston Scientific LithoVue\u2122, 7.5\u2010F PUSEN PU3033, or 6.3\u2010F HugeMed HU30M ureteroscope was inserted through the sheath. Irrigation pressures of 0, 50, 100, 150 and 200\u2009mmHg were applied. No suction was applied. The corresponding steady state IRP and flow rate was recorded. This was replicated in three separate porcine kidneys. Benchtop data were compared to mathematical model predictions. The maximum flow rates that could be achieved with an IRP \u226430\u2009mmHg were extrapolated.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The FANS and ureteroscope geometries affect outflow resistance. Lower outflow resistances, allow higher irrigation pressures and flow rates to be used whilst maintaining an IRP \u226430\u2009mmHg (without suction). Whilst keeping IRP \u226430\u2009mmHg with an 11\/13\u2010F FANS: ~700\u2009mmHg irrigation (~120\u2009mL\/min) could be used with a 6.3\u2010F ureteroscope; ~300\u2009mmHg irrigation (flow rate ~65\u2009mL\/min) could be used with a 7.5\u2010F ureteroscope; ~100\u2009mmHg irrigation (~15\u2009mL\/min) could be used with a 9.5\u2010F ureteroscope.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Using a FANS in the renal pelvis potentially allows for higher irrigation pressures whilst maintaining a low IRP (without the need for suction). With intraoperative monitoring of IRP, irrigation pressure could be increased to achieve flow rates up to 24 times higher than those achievable with gravity irrigation (120 vs ~5\u2009mL\/min).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16865","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T10:34:42Z","timestamp":1758882882000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Flexible and navigable suction access sheaths: balancing sheath and scope size for desired flows"],"prefix":"10.1111","volume":"137","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3449-8594","authenticated-orcid":false,"given":"Richard","family":"Menzies\u2010Wilson","sequence":"first","affiliation":[{"name":"Nuffield Department of Surgery University of Oxford  Oxford 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