{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,7]],"date-time":"2026-06-07T01:02:41Z","timestamp":1780794161439,"version":"3.54.1"},"reference-count":39,"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:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"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"}],"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>To develop an accurate \u2018suction concept\u2019 that should be part of every flexible ureteroscope (FU) and review recent literature on endourology's new technologies to determine if they incorporate all the features of our new concept, as several milestone developments in retrograde intrarenal surgery have led to a re\u2010framing of innovation goals with recent focus on novel laser technology and suction techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature review on the main suction (suctioning ureteric access sheath [SUAS] or flexible and navigable SUAS [FANS], steerable ureteroscopic renal evacuation [SURE], and direct in\u2010scope suction [DISS]) and intrarenal pressure devices during ureteroscopy was conducted from November 2010 until November 2024 using the PubMed and MEDLINE databases. We also develop the \u2018suction concept\u2019 using a 10\u2010stage approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The PubMed and MEDLINE searches returned 329 articles. After duplicate removal and full review of the abstracts and text gathered, 18 full\u2010text articles, product brochures, and peer\u2010reviewed abstract presentations were included for qualitative analysis. To better understand the main purpose of the present study, we divided the results into different sections: FANS, DISS, SURE, and single\u2010use digital FUs with pressure sensor. We compared them to the items checklist that we created to determine if the new FUs or complementary devices fulfil our concept of \u2018suction\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Suction should be viewed as an integrated system and not as a support tool in endourology. The ideal FU should be anatomically flexible, have easy ureteric access, easy manipulation, excellent vision, an integrated energy system, and the five items included in fluid management, including irrigation, suction, pressure control, blockage detection, and automatic unblocking.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bju.16893","type":"journal-article","created":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T11:20:32Z","timestamp":1758885632000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The \u2018suction concept\u2019: everything a flexible ureteroscope should have"],"prefix":"10.1111","volume":"137","author":[{"given":"Olivier","family":"Traxer","sequence":"first","affiliation":[{"name":"Urology Service, AP\u2010HP, Hopital Tenon, Assistance\u2010Publique Hopitaux de Paris Sorbonne Universite  Paris France"},{"name":"GRC n\u00b020, Groupe de Recherche Clinique sur la Lithiase Urinaire, H\u00f4pital Tenon Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aideen","family":"Madden","sequence":"additional","affiliation":[{"name":"Urology Service, AP\u2010HP, Hopital Tenon, Assistance\u2010Publique Hopitaux de Paris Sorbonne Universite  Paris France"},{"name":"GRC n\u00b020, Groupe de Recherche Clinique sur la Lithiase Urinaire, H\u00f4pital Tenon Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1461-8464","authenticated-orcid":false,"given":"Mariela","family":"Corrales","sequence":"additional","affiliation":[{"name":"Urology Service, AP\u2010HP, Hopital Tenon, Assistance\u2010Publique Hopitaux de Paris Sorbonne Universite  Paris France"},{"name":"GRC n\u00b020, Groupe de Recherche Clinique sur la Lithiase Urinaire, H\u00f4pital Tenon Sorbonne Universit\u00e9  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/17562872241232275"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cl2.1230"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-642-55831-3_2"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000001299"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.08.197"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00240-017-1030-x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0838"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apradiso.2023.111143"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-021-03616-6"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.4111\/icu.20200467"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm12010147"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-024-04980-9"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1103\/PhysRevE.74.061402"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2022.0573"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1089\/end.2016.0411"},{"key":"e_1_2_8_17_1","unstructured":"KARL STORZ Endoskope|United States.KARL STORZ and Well Lead medical announce exclusive agreement for distribution of ClearPetra stone\u2010Removal system in the U.S. [Internet]. Available at:https:\/\/www.karlstorz.com\/us\/en\/karl\u2010storz\u2010and\u2010well\u2010lead\u2010medical\u2010announce\u2010exclusive\u2010agreement.htm. Accessed December 2024"},{"key":"e_1_2_8_18_1","unstructured":"Well Lead \u2010 ClearPetra suction\u2010evacuation access sheath|Enhanced Reader [Internet]. Product brochure. Available at:wellead.com. Accessed July 2024"},{"key":"e_1_2_8_19_1","unstructured":"GaoY.ELEPHANT\u2010 II disposable flexible and navigable suction ureteral access sheath\u2010YIGAOMED product information. Available at:https:\/\/www.yigaomedical.com\/en\/product\/. Accessed July 2024"},{"key":"e_1_2_8_20_1","unstructured":"Innovex Medical Co. Ltd.Product brochure [Internet]. Available at:https:\/\/www.innovexmed.com.cn\/. Accessed July 2024"},{"key":"e_1_2_8_21_1","unstructured":"Ureteral access sheath\u2010ureteral access sheath\u2010seplou medical: your partner for urology [Internet]. Available at:http:\/\/www.seplou.com\/wap.asp?content_633. 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