Presented by: T. Max Shelton
Indiana University School of Medicine

Introduction

Advances in endoscopic technology have broadened surgical treatment options for patients with large renal stone burdens. In addition to standard percutaneous nephrolithotomy (PNL), more minimally invasive approaches with mini (MPL) and ultra mini PCNL (UPL) have gained favor. This study evaluates differences in intraoperative fluoroscopic radiation exposure between these three procedures in a retrospective single institution analysis.

Materials

A retrospective review of a all MPL and UPL procedures performed at a single institution between January 2021 and January 2023 was performed. Bilateral surgeries and cases performed with ultrasound guidance or incomplete fluoroscopy records were excluded. In total, 36 MPL and 10 UPL cases were identified. An additional 36 age and gender matched PNL patients were also identified within this same period. Radiation exposure was compared between all 3 procedures using two-tailed T-tests.

Results

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Among the age and gender-matched cohort, no significant difference was noted between the average radiation exposure in SPL 69.8 mGy, MPL 90.6 mGy, and UPL 48.8 mGy (p=0.5622). Although there were marked differences in exposure averages—wide variations in standard deviation limited significance. There were no statistically significant differences in patient BMI or case duration between the procedures.

Conclusion

There appears to be no difference in radiation exposure between SPL, MPL, and UPL in this retrospective cohort. Future prospective studies focusing on procedural radiation exposure are warranted to evaluate for comparison among these techniques.

Funding

None

Co-Authors

Nicole Jansen,
Indiana University School of Medicine

Christoper Schorr,
Indiana University School of Medicine

Peyton Robinson,
Indiana University School of Medicine

RJ Caras, DO
Indiana University School of Medicine

Austen Slade, MD
Indiana University School of Medicine

Marcelino Rivera, MD
Indiana University School of Medicine