A Safety Guidewire Influences the Pushing and Pulling Forces Needed to Move the Ureteroscope in the Ureter: A Clinical Randomized, Crossover Study
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: It is generally advised to keep a safety guidewire (SGW) in the ureter alongside the ureteroscope during endoscopy of the upper urinary tract, but little is known of how the SGW influences the forces exerted on the ureteroscope in the ureter. The purpose of this study was to investigate whether the presence of an SGW during ureteroscopy (URS) in a normal clinical setting will influence the pushing and pulling forces exerted on a semirigid ureteroscope. PATIENTS AND METHODS: In a 1-year period (2010-2011), 40 patients admitted to Haukeland University Hospital for endoscopic treatment of renal pelvic stone disease were included in a clinical randomized crossover trial measuring the forces needed to move a semirigid ureteroscope during URS. A digital force meter was connected to the ureteroscope to perform the force measurements. The pushing and pulling forces were measured at four locations during URS with and without an SGW. The patients were randomized to whether the first series of force measurements should be with or without SGW. Paired-samples t tests were used comparing the forces in the two series. RESULTS: Significantly higher forces were found both when inserting and retracting the semirigid endoscope when an SGW was used compared with times when an SGW was omitted. The mean percentage increase in the forces with an SGW in place varied between 51.8% and 112.5% across locations and directions. A limitation is that the study has been performed with a semirigid ureteroscope only. CONCLUSION: An SGW substantially increased the resistance against moving a semirigid ureteroscope up and down the ureter. The SGW may thus be an obstacle to the ureteroscopic procedure and may even increase the risk of harming the ureter in some patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".