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Vacuum-Assisted Access Sheath Improves Operative Efficiency and Preserves Early Renal Function in Mini-Percutaneous
Hüseyin Biçer1, Abdullah Gölbaşı1, Burak Elmaagac1
1Department of Urology, Kayseri City Hospital, Kayseri, Türkiye.
Journal of Endourology
|July 31, 2026
Summary
Vacuum-assisted access sheath (VAAS) use in 16F mini-percutaneous nephrolithotomy (mini-PCNL) significantly enhances operative efficiency and speeds recovery. VAAS also shows promise for preserving early kidney function compared to conventional access sheaths (CAS).
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrolithotomy
Background:
- Percutaneous nephrolithotomy (PCNL) is a key procedure for kidney stone removal.
- Mini-PCNL utilizes smaller tracts (16F) for reduced invasiveness.
- Optimizing operative efficiency and patient outcomes in mini-PCNL remains an area of research.
Purpose of the Study:
- To compare vacuum-assisted access sheath (VAAS) versus conventional access sheath (CAS) in 16F mini-PCNL.
- To evaluate the impact on operative efficiency, perioperative safety, early renal function, and stone-free status.
Main Methods:
- Prospective comparative study of 80 adults with 2-4 cm renal calculi.
- Patients randomized to VAAS mini-PCNL (n=40) or CAS mini-PCNL (n=40).
- Endpoints included operative times, safety metrics, estimated glomerular filtration rate (eGFR), and stone-free status at 1 month.
Main Results:
- VAAS significantly reduced operative, lithotripsy, and stone clearance times (p<0.05).
- VAAS group showed lower hospital stay and pain scores (p<0.001).
- VAAS preserved early renal function (eGFR) compared to CAS (p<0.05), with higher zero-fragment rates (80% vs 67.5%).
Conclusions:
- VAAS significantly improves operative efficiency and perioperative recovery in 16F mini-PCNL.
- VAAS may offer advantages in preserving early renal function.
- While stone-free rates were similar, VAAS demonstrates procedural and functional benefits.
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