All-Seeing-Access Sheath: A Novel Fluoroscopy-Free Placement Technique in Retrograde Intrarenal Surgery

J Coll Physicians Surg Pak. 2019 Mar;29(3):263-267. doi: 10.29271/jcpsp.2019.03.263.

Abstract

Objective: To evaluate the safety and effectiveness of fluoroscopy-free RIRS (Retrograde intrarenal surgery) method in urolithiasis.

Study design: An observational study.

Place and duration of study: Department of Urology, Hitit University Corum Training and Research Hospital, Corum, Turkey, from October 2014 and October 2017.

Methodology: Preoperative and postoperative data of 62 cases of renal calculi that underwent fluoroscopy-free RIRS procedure by a single surgeon were prospectively evaluated. All manipulations were performed with a novel technique; under direct vision during the operation. Fluoroscopy device was kept at hand in the operating room, but was not used.

Results: The mean age was found as 51.73 ±12.63 (22-82) years. Fortyone patients (66.1%) were males and 21 (33.9%) were females. The mean size of stones were 19.29 ±7.64 (10-40) mm. The stone-free rate was calculated as 42 (67.7%) cases in a single session one month after the surgery, and 15 (24.2%) cases after the second session at the postoperative first month. A total of 57/61 (91.9%) patients were stone-free after the second procedure. No major intraoperative and postoperative complications were observed. As for the minor complications, one patient (1.6%) developed hematuria and four patients (6.5%) had fever.

Conclusion: The described fluoroscopy-free RIRS procedure can be performed effectively and safely in patients diagnosed with renal calculi, by endourologists.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cohort Studies
  • Female
  • Fluoroscopy / methods
  • Follow-Up Studies
  • Humans
  • Kidney Calculi / diagnostic imaging
  • Kidney Calculi / surgery*
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / methods
  • Nephrostomy, Percutaneous / methods*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / physiopathology
  • Retrospective Studies
  • Risk Assessment
  • Treatment Outcome
  • Turkey
  • Young Adult