Computational fluid dynamics analysis of the effect of ureteral access sheath positioning on stone clearance rates

IF 4.8 2区医学 Q1 COMPUTER SCIENCE, INTERDISCIPLINARY APPLICATIONS

Computer methods and programs in biomedicine Pub Date : 2025-07-25 DOI:10.1016/j.cmpb.2025.108978

Yujun Chen, Heng Yang, Xiaofeng Cheng, Haibo Xi, Yue Yu, Wen Deng, Gongxian Wang, Xiaochen Zhou

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Abstract

Background and objective

Standardized protocols for optimal ureteral access sheath (UAS) positioning during flexible ureterorenoscopy (f-URS) lithotripsy have yet to be established. This study utilizes computational fluid dynamics (CFD) techniques to analyze the impact of varying UAS positions on stone clearance rates, aiming to identify the optimal UAS position for enhanced stone fragment evacuation.

Materials and methods

Various f-URS models were created using ANSYS SpaceClaim software. These models were then imported into ANSYS Fluent for meshing and computational simulation. The study evaluated the impact on stone clearance rates as the UAS was incrementally advanced towards the distal end of the f-URS, also observing the effects on local irrigation flow velocity at different UAS positions.

Results

Three models were constructed to simulate stone positions within the renal pelvis, lower calyx, and middle calyx. Each model generated 80 stone particles. In the middle calyx model, the numbers of particles evacuated were 32, 53, 58, and 67 for UAS positions A, B, C, and D, respectively. In the lower calyx model, particle clearance was 15, 21, 37, and 46 for UAS positions A, B, C, and D, respectively. In the renal pelvis model, particle evacuation was 14, 18, 31, and 61 for UAS positions A, B, C, and D, respectively. Position D represents the alignment of the UAS tip flush with the f-URS tip. Stones were deposited in the lower calyx by gravity. Contour plots and vector displays showed the highest irrigation velocity in the UAS and f-URS channels, with a relative low-flow region between the UAS and f-URS tips. When the UAS and f-URS tips were aligned, this low-flow region substantially disappeared.

Conclusions

Ureteral access sheath positioning significantly correlates with stone clearance rates. Maximal stone particle evacuation occurred when the distal tips of the UAS and f-URS were aligned. Variations in UAS position resulted in changes in local irrigation velocity.

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输尿管鞘定位对结石清除率影响的计算流体动力学分析

背景与目的在柔性输尿管镜（f-URS）碎石术中输尿管通路鞘（UAS）最佳定位的标准化方案尚未建立。本研究利用计算流体动力学（CFD）技术分析不同UAS位置对结石清除率的影响，旨在确定增强结石碎片清除的最佳UAS位置。材料与方法利用ANSYS spacecclaim软件建立了各种f-URS模型。然后将这些模型导入ANSYS Fluent中进行网格划分和计算仿真。该研究评估了随着UAS逐渐向f-URS远端推进，对结石清除率的影响，并观察了不同UAS位置对局部灌溉流速的影响。结果构建了3个模型，分别模拟肾盂、下萼和中萼内结石的位置。每个模型生成80个石头颗粒。在中间花萼模型中，UAS位置A、B、C和D分别为32、53、58和67。在下萼模型中，UAS位置A、B、C和D的颗粒清除率分别为15、21、37和46。在肾盂模型中，UAS位置A、B、C和D的颗粒排空量分别为14、18、31和61。位置D表示UAS尖端与f-URS尖端齐平的对准。由于重力作用，石头沉积在较低的花萼中。等高线图和矢量图显示，UAS和f-URS通道的灌溉速度最高，在UAS和f-URS尖端之间存在相对低流量区域。当UAS和f-URS尖端对齐时，该低流区基本消失。结论体外通路鞘定位与结石清除率有显著相关性。当UAS和f-URS的远端尖端对齐时，最大的结石颗粒排出发生。UAS位置的变化导致局部灌溉速度的变化。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Computer methods and programs in biomedicine 工程技术-工程：生物医学

CiteScore

12.30

自引率

6.60%

发文量

601

审稿时长

135 days

期刊介绍： To encourage the development of formal computing methods, and their application in biomedical research and medical practice, by illustration of fundamental principles in biomedical informatics research; to stimulate basic research into application software design; to report the state of research of biomedical information processing projects; to report new computer methodologies applied in biomedical areas; the eventual distribution of demonstrable software to avoid duplication of effort; to provide a forum for discussion and improvement of existing software; to optimize contact between national organizations and regional user groups by promoting an international exchange of information on formal methods, standards and software in biomedicine. Computer Methods and Programs in Biomedicine covers computing methodology and software systems derived from computing science for implementation in all aspects of biomedical research and medical practice. It is designed to serve: biochemists; biologists; geneticists; immunologists; neuroscientists; pharmacologists; toxicologists; clinicians; epidemiologists; psychiatrists; psychologists; cardiologists; chemists; (radio)physicists; computer scientists; programmers and systems analysts; biomedical, clinical, electrical and other engineers; teachers of medical informatics and users of educational software.