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Related Experiment Video

Updated: Jan 28, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

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Reducing Fluoroscopy Time in Percutaneous Nephrolithotomy.

Michael W Sourial¹, Andrew M Todd¹, Marilly S Palettas²

¹1 Department of Urology, The Ohio State University Wexner Medical Center, Columbus, Ohio.

Journal of Endourology

|March 7, 2019

Summary

This summary is machine-generated.

Reducing fluoroscopy time (FT) during percutaneous nephrolithotomy (PCNL) significantly lowers radiation exposure for patients and surgeons. Implementing a radiation reduction protocol (RRP) with techniques like one-spot imaging and tactile feedback proved highly effective.

Keywords:

fluoroscopy nephrolithotomy percutaneous radiation exposure

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Area of Science:

Urology
Medical Imaging
Radiation Safety

Background:

Percutaneous nephrolithotomy (PCNL) utilizes fluoroscopy, a source of ionizing radiation.
Minimizing fluoroscopy time (FT) is crucial for radiation stewardship in patients undergoing stone procedures.

Purpose of the Study:

To evaluate the effectiveness of a radiation reduction protocol (RRP) in decreasing fluoroscopy time during PCNL.
To assess the impact of the RRP on radiation exposure for both patients and urologists.

Main Methods:

Retrospective chart review of 89 PCNL cases (January-October 2017).
Cases divided into pre-RRP (Group 1) and post-RRP (Group 2).
RRP involved low-dose, pulsed fluoroscopy, one-spot imaging, tactile feedback, and shorter live fluoroscopy segments.

Main Results:

Median FT significantly reduced from 240 seconds (pre-RRP) to 65.5 seconds (post-RRP) (p < 0.0001).
No correlation found between FT and increased body mass index (BMI) or stone burden.
Stone-free rates (57-58%) and complication rates (11% overall, 6% major) remained comparable between groups.

Conclusions:

Simple techniques and vigilance can significantly reduce FT during PCNL.
The RRP effectively minimizes radiation exposure without compromising stone-free rates or increasing complications.