Educational content only. This article is not medical advice or an instruction for clinical use.
The conventional access pathway
A ureteral access sheath is used in selected ureteroscopic procedures to provide a route for repeated upper-tract access. Its inner and outer calibres, working length, dilator, tip transition and coating influence the device’s practical fit. The sheath can facilitate instrument exchange, but insertion-related ureteral injury remains an important consideration. It should not be presented as mandatory for every procedure.
What suction adds
Suction-enabled sheath designs introduce an aspiration route intended to assist evacuation of irrigation fluid and, depending on design, selected debris or fragments. This may be relevant to fluid management and visualization. The effect depends on the size and shape of the available outflow path, scope position, irrigation rate, suction settings and the patient’s anatomy. A “suction” label does not establish how one product performs.
FANS is a specific description
Flexible and navigable suction ureteral access sheaths are often abbreviated FANS. The term is not synonymous with every suction-enabled sheath. Some products remain relatively fixed in position; others are engineered to navigate further. Comparisons must identify the exact model, construction, intended use and operating conditions instead of treating all suction devices as a single class.
Clinical literature requires careful translation
The European Association of Urology discusses the influence of outflow, suction and ureteral access systems on intra-renal pressure and irrigation dynamics. That broader discussion does not authorise claims that any particular marketed device prevents complications, reduces urosepsis or guarantees better stone clearance. Such claims need direct model-specific substantiation and an appropriate regulatory basis.
A procurement checklist
Before evaluating a suction platform, request sheath and dilator sizes, length, suction-port geometry, tubing connections, compatible negative-pressure sources, device instructions and related evidence. Compare the complete operating arrangement, including scope and irrigation setup. Asking how a device manages trade-offs is usually more informative than asking for the strongest claim.
Editorial reference
EAU 2026 Urolithiasis guidance [C1]; Advin standard and suction UAS product category pages [A5, A6].