Simultaneous Bilateral Endoscopic Surgery (SBES): Is It Ready for Prime Time?

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrology

Background:

• Simultaneous bilateral endoscopic surgery (SBES) has demonstrated promising outcomes in existing literature.
• The effectiveness and safety of SBES for bilateral renal stones require further investigation.

Purpose of the Study:

• To evaluate the effectiveness and safety of SBES in a series of patients with bilateral renal stones.
• To determine the stone-free rate (SFR) and complication profile of SBES.

Main Methods:

• Prospective analysis of 101 consecutive patients undergoing SBES for bilateral renal stones.
• Preoperative and 1-month postoperative assessments including imaging (CT scan) and laboratory tests.
• Complications were classified using the Clavien-Dindo system.

Main Results:

• An 81.1% stone-free rate was achieved in 82 patients at 1-month follow-up.
• 17.8% of patients experienced Grade I-II complications, and 1% had a Grade IIIa complication (renal arteriovenous fistula).
• 12 patients required additional procedures for residual fragments; 7 had asymptomatic residual fragments.

Conclusions:

• SBES is a safe and effective treatment option for bilateral renal stones.
• Further randomized trials with larger cohorts are needed to solidify SBES as an alternative to staged surgeries.
• Careful patient selection is critical for optimizing outcomes and avoiding severe complications.