Dr. Roger Sur
speaker
102 appearances
1 recordings
1 series
first heard Oct 2024
last heard Oct 2024
Dr. Roger Sur’s voice in public audio — every appearance, attributed to the second.
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He wrote an article saying, you know, stone free rates are nice. But the problem with the stone-free rate is it's kind of a binary. It's a binary outcome. You're either stone-free or you're not stone-free. So the goal, obviously, is to get everyone stone-free. But what if you're not stone-free? Does it matter if you leave a little bit behind or a lot behind? And he suggested, you know what?
Instead of looking at the size of a stone, like a 2-millimeter, 3-millimeter, or 4-millimeter, isn't a stone a three-dimensional object? Shouldn't we be looking at volume of stone? And you think about it, it totally makes sense. It's the volume of the stone that probably makes a lot more sense than the two-dimensional. We're kind of dumbing it down when really we should be looking at volume.
So that I think is one of the futures is to look at how much stone are you leaving behind, you know, and not just in two dimensions, but in three dimensions. which is you can see there's emerging research that's demonstrating the importance of volume.
So I think when you're going to see that more and more that people be talking about volume of stone that's been removed and how much volume is left behind and how that translates to all those things that you were talking about post-op problems.
I think we need you in endourology. It's not too late to convert over. Clearly, with even very little time spent, you already have some good insight into identifying problems that I haven't even thought about.
There have already been 1,500 cases performed with the new 2.0 in the United States. It's only available in the United States currently. But yeah, community urologists, All types of urologists have used this already, as well as FANS has been used all throughout the United States by all types of urologists. You don't need to have special training for any of this.
I do think they recommend probably a couple of mentored cases with your territory manager from the company, just making sure you're using the best practices. But no, this does not require specialized training.
Well, I think that number is evolving. What I say today is going to be even greater in a month from now. Like having seen some of the numbers that I've seen of utilization of suction devices and their uptake in the market, it's almost asymptotic. It's really increasing dramatically.
Well, we know that dusting compared to just fragmenting and basketing can be a little bit longer in operative time. So that being said, when the final studies are done, it would not surprise me if there's a slight increase in operative time. But if that time is a couple of minutes in exchange for having to come back to the O.R.,
And or readmitting your patient for, you know, obstructing stone or a patient coming to the hospital with an infection and sepsis. Wouldn't it make sense to spend that extra whatever couple of minutes, whether it's single digit minutes or even double digit minutes? I don't think we're talking large amounts of time, but yeah, that's probably the difference is we're talking.
Not like hours or anything. We're just talking minutes of differences, probably, which translate huge for post-op for the patient.
plug and play see what's going to work well for my hands how do i actually make this happen you just simply call these companies up and they would be happy to come to your hospital once this you know the device has been approved by your vac committee i'm sure a trial is set up and then you get to try the different devices to see what which device makes sense to you it's not challenging there's the barriers are not huge they're very low
Any capital equipment requirements for any of these? Definitely not for fans because that's literally a high-speed access sheet. The CVAC does have a control box, but kind of like any reader scope, digital reader scope, it has a control box. It's pretty tiny. It's about the size of a large laptop maybe. I don't know the answer to that as far as the capital of that.
In fact, my sense, I don't want to speak, I'm really not sure.
Yeah, because your scope plugs into the box. It doesn't plug into your striker system or your Olympus system to your monitor. It plugs into the box, then the box plugs into your monitor. So it is an intermediate box or step that you do need. It's my sense that... The cost is simply, I'm almost 100% positive the more I think about it now. I had privy to look at some of the costs and whatnot.
The hospital is simply paying for the device, the CVAC device, in the case of CVAC, and getting reimbursed, actually, obviously. In fact, there is a transitional pass-through payment code for single-use scopes that can be applied for Medicare patients. So that really lowers the cost to the hospital. And in fact, the CVAC has a unique definition
facility reimbursement code that's different than just ureteroscopy. So for in the United States, that has a huge effect on for the hospital and for the providers.
Yeah. Well, the cool thing is there's so many other issues. You've already touched upon some of the things that where we can do it better and better and better. And I'm excited maybe to come back on the show one day and tell you what we're doing and share what other people are doing and how ureteroscopy has suddenly made another huge leap or something else within stone surgery.
So that's the best part of all of this.
Well, I think there's new technology available. There are not huge obstacles to adopting these technologies. And the data suggests that it definitely improves the stone-free rates and lowers the infection rates. So if the learning curve is not huge, which it is not for these devices, then why not adopt them? And I think you'll see for yourself why people are really excited about suction devices.
Showing 81–100 of 102 · page 5 of 6
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