Fluoroscopy-free RIRS on the second session after ureteral stent placement

Area of Science:

• Urology
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Conventional Retrograde Intrarenal Surgery (RIRS) often utilizes fluoroscopy, which carries risks of radiation exposure.
• Passive dilatation techniques are employed in some RIRS procedures.
• Minimizing radiation exposure in urological procedures is a significant clinical goal.

Purpose of the Study:

• To evaluate the safety and effectiveness of a fluoroscopy-free technique in patients undergoing a second session of RIRS.
• To assess outcomes after passive dilatation in fluoroscopy-free RIRS.

Main Methods:

• Retrospective evaluation of 54 cases of second-session RIRS performed by a single surgeon.
• Data collected included patient demographics, stone characteristics, operative time, and complications.
• A modified surgical technique was used, and outcomes were classified as stone-free, clinically insignificant residual fragments, or residual stones.

Main Results:

• No major complications (Clavien grade III-IV) were observed; all complications were minor.
• The stone-free rate was 70.3% on postoperative day one and 83.3% at one month.
• Overall success, including clinically insignificant residual fragments, reached approximately 91% at one month.

Conclusions:

• The fluoroscopy-free technique demonstrates a high stone-free success rate and a low complication profile.
• This approach is safe and effective for secondary-session RIRS cases following passive dilatation.
• The technique offers a viable radiation-free alternative for experienced endourologists.