Single Pulse-per-second Setting Reduces Fluoroscopy Time During Ureteroscopy

Yecies, Todd; Fombona, Anisleidy; Semins, Michelle Jo

doi:10.1016/j.urology.2017.01.019

Cited by 15 publications

(7 citation statements)

References 19 publications

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“…Hsi et al [7] investigated FT during URS in their prospective study, which included 105 patients with ureteric and renal stones (162 renal units). In that study, a step-wise URS protocol was described and it was found that URS could be performed with the fluoroless protocol in 75% of the patients, whilst in 85% the FT was ≤ 2 s and in 95% the FT was ≤ 5 s. Yecies et al [9] evaluated the effect of 1 pps fluoroscopy on FT and surgeon radiation exposure during URS. The authors included in the study a total of 84 patients and 70 underwent URS using continuous and 1 pps fluoroscopy, and found that 1 pps fluoroscopy is feasible, significantly reduces FT, and lowers surgeon radiation exposure by 64%.…”

Section: Discussionmentioning

confidence: 99%

“…The use of fluoroscopy in urological procedures has some risks such as malignancy inducement from radiation exposure of the patient, surgeon, and operation room staff [4,5]. There are some studies that have investigated the possibility of fluoroless URS during the treatment of stone disease [6][7][8][9][10][11]. In the present study, we investigated the feasibility and effectiveness of fluoroless (zero-dose) fURS (ffURS) for renal stone treatment in a large patient population.…”

Section: Introductionmentioning

confidence: 99%

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Is fluoroscopy necessary during flexible ureteroscopy for the treatment of renal stones?

Kirac

Köprü

Ergin

et al. 2019

Arab Journal of Urology

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Objective: To investigate the feasibility and effectiveness of flexible ureteroscopy (fURS) without fluoroscopy during the treatment of renal stones. Patients and methods: Between April 2013 and August 2018, 744 patients' data were evaluated retrospectively. Of these, 576 patients were included in the study. All fURS were performed by experienced surgeons. All procedures were planned with zero-dose fluoroscopy. But, if fluoroscopy was necessary for any reasons, these patients were excluded from the study. Demographic data, perioperative parameters, stone-free rate (SFR), and complication rates were recorded. Results: Of the patients planned for fluoroless fURS (ffURS), the procedure was successfully achieved in 96.7% (557/576 patients), as 19 patients required fluoroscopy during the procedure for various reasons. In the patients included in the study, the mean (SD) stone size was 11.6 (5.2) mm and the mean (SD) operating time was 39.4 (8.2) min. After the first session of ffURS, the SFR was 83.3% (achieved in 464 patients). Second and third sessions of ffURS were performed in 32 (5.7%) and seven (1.2%) patients, respectively. Overall, the complication rate was 11.8% and all complications were minor (Clavien-Dindo Grade I or II). Conclusions: The ffURS technique seems to be a safe and effective treatment compared to conventional fURS in patients with renal stones. This procedure should be performed in experienced centers, where fluoroscopy can be considered not to be mandatory during fURS.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Is fluoroscopy necessary during flexible ureteroscopy for the treatment of renal stones?

Kirac

Köprü

Ergin

et al. 2019

Arab Journal of Urology

View full text Add to dashboard Cite

show abstract

“…Various measures are routinely employed to reduce radiation exposure during fluoroscopy. Examples include utilizing lead shielding and employing single-pulse per second images [6]. In addition, alternative subspecialties are developing techniques to reduce the use of intraoperative fluoroscopy, including cardiology, vascular, and neurosurgery, orthopedics, radiology, and others [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

“…ultrasound, smaller instruments, and new procedural techniques [6,[10][11][12][13]. There have been several techniques described in the literature aimed at reducing the usage of fluoroscopy during routine ureteroscopic stone surgery [2,[10][11][12][13][14][15].…”

Section: Introductionmentioning

confidence: 99%

“…In a similar fashion, urologists are pursuing methods in order to lower the amount of radiation used during ureteroscopy. Described interventions include surgeon education, C-arm aiming lasers, fluoroscopy settings, use of ultrasound, smaller instruments, and new procedural techniques [ 6 , 10 - 13 ]. There have been several techniques described in the literature aimed at reducing the usage of fluoroscopy during routine ureteroscopic stone surgery [ 2 , 10 - 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Reducing Radiation Exposure to Patients and Staff During Routine Ureteroscopic Stone Surgery: Adopting a Fluoroless Technique

clark¹,

King²,

Patel³

et al. 2021

Cureus

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Urologists have an obligation to limit radiation exposure during routine stone surgery. We therefore sought to evaluate the impact of our technique for fluoroless ureteroscopy on perioperative outcomes. MethodsMedical records of 44 patients who underwent ureteroscopy with laser lithotripsy without the use of fluoroscopy between October 2017 and December 2018 were examined. Multiple variables were collected, including age, body mass index (BMI), mean stone volume and density, operative times, complications, and stone-free rates. These patients were then compared to a cohort of 44 patients who underwent stone surgery with a conventional technique prior to the adoption of a fluoroless technique by the same surgeons. The primary study outcome was reduction of intraoperative fluoroscopy. Secondary outcomes included complications, operative time, and stone-free rates. ResultsOf the 44 patients undergoing a fluoroless technique, 38 (86.4%) were able to receive ureteroscopy without the use of fluoroscopy. A significant difference was observed in mean fluoroscopy times for the fluoroless group (2.8 seconds) and the conventional group (33.7 seconds). No complications were observed in either group. Operative length was 38.9 minutes in the fluoroless group versus 42.2 minutes in the conventional group. Age, BMI, stone characteristics, and stone-free rates were similar in both. ConclusionsThe use of a fluoroless technique for the treatment of uncomplicated stones is not only safe but also effective and efficient. This technique eliminates extraneous radiation doses to the patient and operative staff in most cases.

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Radiation Safety During Surgery for Urolithiasis

Inoue

Matsuda

2019

Ureteroscopy

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Single Pulse-per-second Setting Reduces Fluoroscopy Time During Ureteroscopy

Cited by 15 publications

References 19 publications

Is fluoroscopy necessary during flexible ureteroscopy for the treatment of renal stones?

Is fluoroscopy necessary during flexible ureteroscopy for the treatment of renal stones?

Reducing Radiation Exposure to Patients and Staff During Routine Ureteroscopic Stone Surgery: Adopting a Fluoroless Technique

Radiation Safety During Surgery for Urolithiasis

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