Comparison of the Radiation Protection Effectiveness between Lead and Antimony-Tungsten Bed Skirt in Fluoroscopic-guided Simulated Urological Surgery

Abstract

Objective: This study aimed to develop a new shielding device, a bed skirt, and compare the radiation protection effectiveness between lead and antimony-tungsten (Sb-W) bed skirts in fluoroscopic-guided urological surgery. Material and Methods: The simulated surgery of ureteroscopy (URS) and percutaneous nephrolithotomy (PCNL), using the phantoms, was set. The lead and Sb-W skirts were mounted around the operating table. The fluoroscopy time was 120 seconds, and the experiment was repeated 10 times. The radiation dose to the body parts of the patient, surgeon, and anesthesiologist was measured with optically stimulated luminescent dosimeters and compared in the following conditions: conventional operating table, Sb-W bed skirt, and lead bed skirt.Results: By installing a bed skirt, the radiation dose was decreased, with lead being dominant in all areas. The lead bed skirt reduced the radiation dose by 20% to the patient, 66% to the surgeon, and 91% to the anesthesiologist. The absorbed radiation dose of the lead bed skirt was lower than the Sb-W bed skirt in URS settings (23.3±1.8 µGy vs 32.0±1.9 µGy, p-value<0.001) as well as PCNL settings (257.2±15.6 µGy vs 296.5±24.6 µGy, p-value<0.001). There was no statistically significant difference between the conventional operating table and the Sb-W bed skirt in both URS settings (p-value=0.066) and PCNL settings (p-value=0.153).Conclusion: The lead bed skirt significantly reduced the radiation exposure and provided superior radiation protection compared with the Sb-W bed skirt. This shielding technique is practical to minimize the harmful effects of radiation from fluoroscopy.