LAUSR

BACKGROUND We aimed to define the published impact, efficacy, cost-effectiveness, and precise role of the Isiris-αTM device: the world's first sterile, Single-Use Grasper Integrated Flexible Cystoscope (SUGIFC) for ureteral stent removal. METHODS After PROSPERO registration (CRD42021228755), the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines were utilized. The search terms 'Grasper Integrated Flexible Cystoscope', and 'Isiris', within the following databases: PubMed, Scopus, Cochrane Library, Web of Science, and EMBASE were searched. RESULTS In this review, a cumulative total experience (10 publications) included 970 'SUGIFC' procedures (755 patients). However, only 366/970 procedures were actually used for 'ureteral stent removal', with the remainder being surveillance cystoscopy only (603/970) or foreign body retrieval (1/970). Procedure-related and device failures in planned 'removal of ureteral stents', was reported in 8/366 (346 patients) and 1/366 (346 patients) respectively. The cost-benefit utilizing the SUGIFC device is advantageous compared to 'in-theatre' stent removals and favours less busy centres where maintenance, repair, and replacement costs are more relevant. Other listed benefits include shorter stent indwelling times, shorter procedure duration, lower rates of bacteriuria and urinary tract infections, fewer Emergency Department visits and lower readmission rates. Technical limitations include the absence of an independent working channel, a narrower visual field, and the lack of image universality since the monitor is device-specific. CONCLUSION The SUGIFC device needs to be outweighed against local costs and individual health systems. Its application in ambulatory ureteral stent removal may become significant due to the accessibility and convenience that it offers the attending urologist.