Development of a novel percutaneous digital flexible nephroscope: its use and application.

BACKGROUND: Renal calculi are one of the most frequent diseases in urology, and percutaneous nephrolithotomy (PCNL) being the gold standard for treating renal calculi larger than 2 cm. However, traditional rigid nephroscope cannot bend, presents significant limitations during PCNL. This study aims to develop a novel digital flexible nephroscope for PCNL and verify its safety and efficacy using 3D printed models and ex vivo porcine kidney models, providing new equipment for PCNL. METHODS: Based on the determined technical parameters, the novel digital flexible nephroscope was manufactured. First, 3D-printed model and ex vivo porcine kidney models were utilized to simulate the PCNL procedures. Then, the traditional rigid nephroscope and the novel digital flexible nephroscope were utilized to simulate the PCNL procedures on 10 ex vivo porcine kidneys for comparison. We observed and recorded the renal calyces visualized and accessed by both the traditional rigid nephroscope and the novel digital flexible nephroscope. RESULTS: In both the 3D printing and ex vivo porcine kidney models, the novel percutaneous digital flexible nephroscope smoothly entered the renal collecting system through the percutaneous renal tract. It freely changed angles to reach most target calyces, demonstrating significant advantages over the traditional rigid nephroscope. CONCLUSION: The successful development of the novel percutaneous digital flexible nephroscope allows it to be used either independently or as an adjunct in complex stone cases, providing more effective and safer surgical equipment for percutaneous nephrolithotomy.

Formulation of PG-FA-L composite modifier for repairing expansive soil based on the statistical mixed design method.

The generation of large amounts of solid waste has led to exploration of solid waste-modified expansive soils; however, the effect of a single solid waste-modified expansive soil is not ideal. This study proposes a composite modification of expansive soils using a PG-FA-L system. Statistical analysis showed that the properties of the cured soil were significantly improved. PG and FA increased soil strength after a certain threshold, and L increased it at all stages. The presence of PG accelerated the volcanic ash reaction. Both PG and FA have a small effect on the swelling of the soil, whereas lime improves it significantly, but has a negative effect after a certain threshold. The 28-day unconfined compressive strength and deformation characteristics were used to derive the relevant regions for roadbed fill requirements and determine the optimum dosage.