One- versus two-surgeon active stone retrieval procedures for flexible ureteroscopy: An off-site simulator...

Area of Science:

• Urology
• Surgical Techniques
• Endourology

Background:

• Flexible ureteroscopy is a key procedure for treating kidney stones.
• Current techniques often involve two surgeons, potentially increasing resource utilization.
• Evaluating novel, potentially more efficient, surgical approaches is crucial for advancing patient care.

Purpose of the Study:

• To compare the efficacy of a one-surgeon basketing technique versus a conventional two-surgeon method for renal stone extraction during flexible ureteroscopy.
• To assess operative efficiency and instrument handling between the two techniques.

Main Methods:

• Seven urologists performed renal stone extractions using both one-surgeon and two-surgeon techniques on an off-site simulator.
• Key metrics analyzed included total task completion time, number of basket forceps manipulations, and unexpected events.
• Surgeons were categorized as trained or less-trained to evaluate skill-level impact.

Main Results:

• No significant difference in overall task completion time was observed between the one-surgeon and two-surgeon techniques.
• Trained surgeons demonstrated significantly faster stone extraction times using the one-surgeon technique (P=0.049).
• The one-surgeon technique required significantly fewer basket forceps manipulations (P=0.018).

Conclusions:

• The one-surgeon basketing technique offers comparable efficacy to the two-surgeon method for flexible ureteroscopy.
• With adequate surgeon training, the one-surgeon approach represents a viable and potentially more efficient modality for renal stone extraction.
• This technique may offer advantages in terms of instrument efficiency and potentially reduce operative time for experienced surgeons.