Patient position and semi-rigid ureteroscopy outcomes

Area of Science:

• Urology
• Surgical Techniques
• Medical Device Optimization

Background:

• Ureteroscopy (URS) is a common procedure for treating ureteral calculi.
• Two patient positions are utilized: dorsal lithotomy (DL) and dorsal lithotomy with the same side leg slightly extended (DLEL).
• The impact of patient positioning on URS outcomes requires further investigation.

Purpose of the Study:

• To compare the operative outcomes of URS performed in the DL position versus the DLEL position.
• To evaluate the effect of patient leg positioning on surgical efficiency and success rates.

Main Methods:

• A prospective randomized study involving 98 patients with ureteral calculi.
• Patients were assigned to either the DL or DLEL position for URS.
• Evaluation of patient demographics, stone characteristics, operative time, fluoroscopy use, complications, and success rates.

Main Results:

• Operative time was significantly shorter in the DLEL group (62.0 minutes) compared to the DL group (81.0 minutes).
• This reduction in operative time was particularly notable in male patients.
• No significant differences were observed in mean fluoroscopy use, complication rates, or success rates between the two positions.

Conclusions:

• Patient leg positioning is a modifiable factor that can influence operative time during URS.
• The DLEL position offers a simpler and faster surgical approach compared to the DL position.
• While not impacting success or complication rates, the DLEL position enhances surgical efficiency.