Flexible Ureteroscope Graspers and Stone Baskets: A Selection Guide for OR Teams

Baskets, graspers and forceps: what each does

A stone retrieval basket is a set of wires, commonly nitinol, that opens inside the ureter or calyx to trap a stone or fragment and then closes to withdraw it. Graspers and forceps have jaws that clamp onto a fragment or tissue. Tipless baskets avoid a rigid tip that could injure the urothelium.

Which tool is used depends on the stone, its position and the surgeon’s preference. From an inventory view, you will usually stock a few basket designs, one or two graspers and, if the scope is used with a laser, a set of fibers.

Training the scrub team matters too: opening and closing a basket under vision, releasing a stone that is too large and recognising a trapped basket are practical skills that benefit from a simulation session before the first case. Ask your supplier whether they provide hands-on instruction with the accessories.

Sizes and channel compatibility

Accessories are quoted in French. The scope channel limits the maximum size, and the channel is narrower while the scope is deflected. A 3 Fr basket needs a channel that can pass it without friction; a 1.9 Fr or 2.2 Fr design leaves more room for irrigation.

The Richard Wolf COBRA has a 3.6 Fr working channel and a separate 2.4 Fr laser channel for fibers up to 365 µm, which keeps the main channel free for a basket during lithotripsy. Always check the accessory maximum outer diameter in writing before ordering and confirm it passes with the scope deflected.

• Basket wire material: nitinol is common for flexibility
• Tipless vs tipped designs
• Outer diameter in Fr and the minimum channel size
• Handle type and opening mechanism
• Reusable or single-use

Reusable vs single-use accessories

Single-use baskets arrive sterile and need no reprocessing, but they add per-case cost. Reusable graspers and forceps are cleaned and sterilised, which lowers per-case cost but requires inspection of the jaws, wear checks and a reprocessing cycle that does not damage the delicate parts.

Decide by volume, reprocessing capacity and your quality system. Whatever you choose, follow the manufacturer’s instructions for use. For the surrounding equipment see flexible ureteroscopy step by step and the ureteral access sheath guide.

Laser fibers and basket interaction

A laser fiber and a basket may occupy the same channel, so their combined diameter matters. Fire only with the fiber visible and clear of the basket wires, since laser energy can damage basket wires and the scope. A dedicated laser channel, as in COBRA, reduces the conflict.

Fiber core size also affects what is left of the channel. Read our laser fiber guide for core sizes, and note the laser device itself, for example the MegaPulse 70+.

Stocking and buying checklist

Standardise on a few designs and sizes, keep spares of the most used basket and confirm compatibility with every scope in your fleet. Keep a record of lots for single-use items and a usage log for reusable ones. Ask suppliers about registration of the accessories, as requirements change; confirm with MOHAP, DHA or DOH.

Beckfinity can help match accessories to the scopes and lasers in your department. Share your scope list on the contact page and request a quote.

Finally, store accessories in a way that protects the delicate wires and jaws: dedicated trays or holders, with expiry dates visible for sterile single-use items. A short checklist at the start of each list prevents the situation where the right scope is ready but the right basket is missing.