Risk of radiation exposure during PCNL

Area of Science:

• Urology
• Medical Physics
• Radiation Safety

Background:

• Fluoroscopic guidance is standard in endourology.
• Medical staff, including physicians and assistants, face radiation exposure from scatter.
• Reporting radiation dose measurements for staff is often overlooked.

Purpose of the Study:

• To quantify radiation doses experienced by medical staff during percutaneous nephrolithotomy.
• To identify areas of highest radiation exposure for surgical teams.

Main Methods:

• Radiation exposure was measured in 100 percutaneous nephrolithotomy cases.
• Lithium fluoride thermoluminescent dosimeters were used to record doses.
• Dosimeters were placed on the surgeon, assistant, and nurse at the head, eyes, fingers, and legs.

Main Results:

• Mean screening time was 4.5 minutes (73 kVp, 2.8 mA).
• Surgeon's scatter exposure rates (microGy) at 40 cm: head 0.47, eyes 0.04, fingers 0.21, legs 4.1.
• Assistant's scatter exposure rates (microGy): head 0.05, eyes 0.01, fingers 0.025, legs 0.1. Nurse exposure was negligible (0 microGy).

Conclusions:

• Fluoroscopic screening during endourological procedures leads to measurable radiation exposure for staff.
• The operating surgeon absorbs the highest radiation dose, primarily on the legs.
• Radiation exposure is significantly lower for assistants and negligible for circulating nurses.