Influence of surgeon's experience on fluoroscopy time during endourological interventions

Area of Science:

• Urology
• Medical Imaging
• Radiation Safety

Background:

• Fluoroscopy time is a key factor in radiation exposure for patients and surgeons during endourological procedures.
• Understanding how surgeon experience influences fluoroscopy habits is crucial for optimizing radiation safety.

Purpose of the Study:

• To evaluate changes in fluoroscopy habits among endourological surgeons after receiving feedback on their fluoroscopy times.
• To assess the impact of surgeon experience on the ability to reduce fluoroscopy and operation times.

Main Methods:

• 402 endourological interventions (ureter stent placement, ureter stent change, nephrostomy change, ureterorenoscopy, percutaneous nephrolithotomy) were analyzed.
• Surgeons were categorized by experience (>2 years vs. <2 years).
• Fluoroscopy time and operation time were recorded before and after surgeons received feedback on their performance.

Main Results:

• Surgeons reduced median fluoroscopy times by up to 55% after receiving feedback.
• Experienced surgeons significantly reduced operation and fluoroscopy times for simpler procedures (USP, USC, NC).
• No significant reduction in operation or fluoroscopy times was observed for complex procedures (URS, PCNL) or by inexperienced surgeons.

Conclusions:

• Informing experienced surgeons about their fluoroscopy time can significantly decrease radiation exposure during less complex endourological interventions.
• Inexperienced surgeons have a limited ability to modify their fluoroscopy habits even with feedback.