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Radiation protection in percutaneous renal surgery
W G Bowsher1, P Blott, H N Whitfield
1Department of Urology, St Bartholomew's Hospital, London.
British Journal of Urology
|March 1, 1992
Summary
Radiation exposure during percutaneous nephrolithotomy (PCNL) is a concern for urologists. While current dose limits are unlikely to be exceeded with precautions, a 30% reduction may be needed, and monitoring methods require improvement.
Area of Science:
- Urology
- Medical Physics
- Radiation Safety
Background:
- Percutaneous nephrolithotomy (PCNL) involves significant radiation exposure for urological surgeons.
- Disparate radiation dose findings from different British centers necessitate further investigation.
- Accurate assessment of surgeon exposure, particularly to eyes and fingers, is crucial for occupational safety.
Purpose of the Study:
- To determine the radiation exposure levels for experienced urological surgeons during PCNL.
- To evaluate the effectiveness of specific radioprotective gloves in reducing radiation dose.
- To assess current monitoring practices and recommend improvements for radiation safety in PCNL procedures.
Main Methods:
- Measurement of radiation doses to the eyes and fingers of a urological surgeon during PCNL.
- Evaluation of selected radioprotective gloves for their shielding efficacy.
- Analysis of radiation monitoring techniques, including the adequacy of routine dosimeters.
Main Results:
- With judicious use of screening and other precautions, current radiation dose limits are unlikely to be exceeded.
- A potential 30% reduction in dose limits may be warranted based on findings.
- Routine radiation badges worn under lead aprons are insufficient for accurate exposure monitoring.
Conclusions:
- Urologists should advocate for enhanced radiation monitoring assistance from radiation protection officers.
- The use of ultrasound technology should be encouraged to minimize fluoroscopy time and radiation exposure.
- Implementing specific precautions can manage, but may not entirely eliminate, radiation risks during PCNL.