Abstract
Background/aim In this study, we aimed to present our results on single-guidewire flexible ureteroscopy and retrograde intrarenal surgery without fluoroscopy and an access sheet, and to evaluate the efficacy and safety of this procedure retrospectively.Material and methodsOur routine technique can be described as the evaluation of the ureter using a semirigid ureterorenoscope (URS), leading in the guidewire through the semirigid URS, pulling the semirigid URS back, inserting the flexible URS with the aid of the guidewire, inserting the laser probe through the flexible URS, and performing laser lithotripsy. Results Our study included 400 male and 198 female patients with a mean age of 36.8 ± 16 (14–80) years. The mean stone size was 8.7 ± 4 (8–20) mm, and the mean operation time was 56 (32–106) min. Postoperative fever was observed in 24 (4%) of the patients, and 30 (5%) patients had hematuria as a minor complication. A stone-free status was observed in 466 (78%) patients, while 102 (17%) patients had clinically insignificant minor stone fragments and 30 patients had clinically significant stone residue. Conclusion The retrograde intrarenal surgery procedure using only a guidewire without fluoroscopy and an access sheet in the treatment of kidney stones is technically safe and effective.
Highlights
The primary aim in the treatment of renal stones is to achieve minimum morbidity and maximum stone-free status
In the classical application of retrograde intrarenal surgery (RIRS), fluoroscopy is needed for the insertion of the access sheet, allowing for the placement of the guidewire and an easy approach to the kidney stone [3,4]
We aimed to evaluate the results and benefits of using the RIRS technique without fluoroscopy or an access sheet
Summary
The primary aim in the treatment of renal stones is to achieve minimum morbidity and maximum stone-free status. Treatment modalities for kidney stones have changed significantly in recent years, and alternative, minimally invasive methods have gained importance. While in past years kidney stone treatment has been performed only through open surgery, less invasive surgical methods are frequently used, including percutaneous nephrolithotomy, extracorporeal shock wave lithotripsy (ESWL), and retrograde intrarenal surgery (RIRS) [1]. The development of small ureterorenoscope (URS) devices and improvements in their deflection angles and optical systems have made the RIRS procedure popular in the treatment of kidney stones [2]. In the classical application of RIRS, fluoroscopy is needed for the insertion of the access sheet, allowing for the placement of the guidewire and an easy approach to the kidney stone [3,4]. Because of exposure to radiation during fluoroscopy, both the patient and the surgeon are at risk of developing pathologies such as secondary tumors, infertility, and
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