Can We Avoid Radiation Exposure in Retrograde Intrarenal Surgery?

Area of Science:

• Urology
• Minimally Invasive Surgery
• Medical Imaging

Background:

• Fluoroscopy use in Retrograde Intrarenal Surgery (RIRS) leads to radiation exposure for patients and staff.
• Managing renal stones < 2 cm often involves RIRS, necessitating evaluation of radiation-reducing techniques.

Purpose of the Study:

• To assess the efficacy and safety of fluoroscopy-free (FF) RIRS.
• To compare FF-RIRS with fluoroscopy-assisted (FU) RIRS in patients with renal stones < 2 cm.

Main Methods:

• Retrospective analysis of 255 patients undergoing RIRS for renal stones < 2 cm.
• Patients were randomized into FF-RIRS (132 patients) and FU-RIRS (123 patients) groups.
• Key outcomes included operative time, complications, length of stay, and stone-free rates (SFR).

Main Results:

• FF-RIRS had significantly shorter operative times (34.7 min vs. 42.0 min, p < 0.001).
• Postoperative complication rates were lower in the FF group (21.9% vs. 34.1%, p = 0.030).
• No significant differences in length of stay or SFR were observed between groups.

Conclusions:

• Fluoroscopy-free RIRS is an effective and safe option for selected patients with renal stones < 2 cm.
• Experienced surgeons can achieve shorter operative times and reduced complications using FF-RIRS.
• This technique minimizes radiation exposure without compromising stone clearance or hospital stay.