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Les avancées technologiques en endo-urologie font désormais de l'urétéroscopie souple (URSS) une technique de choix pour traiter les calculs urinaires mais aussi un casse-tête lorsqu'il s'agit de choisir son équipement. La mise en place d'un guide de sécurité au sein des cavités rénales (nitinol, 0,035″, « stiff ») par cystoscopie rigide est non obligatoire mais constitue un critère de sécurité. Il en est de même concernant les gaines d'accès urétéral, celles avec aspiration étant en cours d'évaluation. Si leur utilisation réduit la pression et la température au sein des cavités rénales facilitant la vision, leur insertion peut occasionner des lésions urétérales. Les systèmes d'irrigation utilisant la gravité avec pompe manuelle sont à privilégier pour minimiser le risque de barotraumatisme. Le choix de l'urétéroscope est complexe : diamètre, capacité de déflexion, position du canal opérateur et qualité de vision sont à considérer. Aussi, il est difficilement envisageable de n'utiliser qu'un modèle endoscope pour l'intégralité des URSS. Les lasers Holmium:Yttrium-Aluminium-Grenat (Ho:YAG) et Thulium Fibré (TFL) sont aujourd'hui recommandés pour le traitement des calculs urinaires en URSS, avec un avantage potentiel du TFL pour la pulvérisation fine. Les paniers sont nombreux et divers, leur taille et forme devant également être considérées avant acquisition. En fin d'intervention, un drainage urétéral n'est pas systématique, mais les sondes JJ en silicone ont montré des risques d'incrustation et de gêne fonctionnelle plus faibles que les sondes faites de polyuréthane. Flexible ureteroscopy is now widely used as the preferred option to surgically treat a urinary stone, due to several technological advancements. Thus, choosing the adequate equipment is challenging, but respects safety concepts. Indeed, placing the safety wire (nitinol, 0,035″, "stiff") under rigid cystoscopy is not mandatory but improve safety. Regarding ureteral access sheath (UAS), considerations are similar: UAS facilitates vision, pressure and temperature control but can also be responsible of ureteral injuries at insertion. Suction devices are now under evaluation and could not be discussed. To limit the barotrauma risk, irrigation devices with manual pumps should be used (40 cmH 2 0). Choosing a flexible ureteroscope (fURS) is challenging; a special attention has to be given to size, deflexion, working channel position and vision. Thus, using a single fURS is hardly imaginable. Both Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) and Thulium Fiber (TFL) lasers are recommended to treat urinary stones during fURS, with a potential advantage of TFL on thin pulverization. A wide variety of baskets exists and size and shape have to be considered before acquisition. Finally, if ureteral stenting is not mandatory in uncomplicated cases, silicone stents present a lower risk of encrustation and stent-related symptoms compared to polyurethane ones. [ABSTRACT FROM AUTHOR]

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Proges en Urologie is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Minimally Invasive Surgery (MIS) consists of the insertion of a flexible endoscope into the patient body through natural orifices. Over the past few decades, the growing interest in microelectromechanical systems (MEMS) has paved the way for ubiquitous miniaturized integrated sensors and actuators in medical endoscopy. Nowadays, recent advances in materials have opened a promising way to fulfill the surgical requirements and size constraint for the development of smart continuum structures. Among smart materials, electroactive polymers (EAPs) exhibit exceptionally large, fast, repeatable, and reversible motions while perfectly meeting the requirements of micro-integration. However the high applied voltage required for the actuation is not compatible with in vivo medical application. To overcome these issues, a multilayered concept has been proposed. In this work a relaxor ferroelectric electrostrictive polymer is studied for its large electromechanical strain. A wide range of parameters involved in the active material has led us to the development of a finite element model on Abaqus to guide the experimental development. Then, to control this smart endoscopic robot a kinematic and a dynamic models have been built. To test and validate these models a Co-simulation procedure has been developed. This procedure coupled Abaqus and Matlab-Simulink allowing testing proposed control algorithms. [ABSTRACT FROM AUTHOR]