You have accessJournal of UrologyStone Disease: Surgical Therapy V (MP65)1 Sep 2021MP65-13 AMBULATORY PERCUTANEOUS NEPHROLITHOTOMY PERFORMED IN A FREE-STANDING SURGERY CENTER: OUTCOMES OF 1000 CASES MD Meagan Dunne, , MD Natalia Ariasvillela, DO Joel Abbott, and MD Julio Davalos MD Meagan DunneMD Meagan Dunne More articles by this author , More articles by this author , MD Natalia AriasvillelaMD Natalia Ariasvillela More articles by this author , DO Joel AbbottDO Joel Abbott More articles by this author , and MD Julio DavalosMD Julio Davalos More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002105.13AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Percutaneous Nephrolithotomy (PNL) is a procedure that has traditionally been performed in an inpatient setting with at least an overnight stay. Many surgical procedures have evolved over time from an inpatient setting to an ambulatory surgery center (ASC) setting. Feasibility of Ambulatory PNL (aPNL) was shown in our initial pilot series of 25 cases [1]. This 1000 case series is reviewed to further evaluate outcomes with a more robust data set. METHODS: We present our series of 1000 patients who underwent PNL in an ASC from April 2015 to January 2021. Each aPNL was performed by one of two surgeons with the same operative team. All procedures were performed with the urologist obtaining renal access and all procedures were performed tubeless (ureteral stent without a nephrostomy tube). All patients also had hemostatic plugs placed into the access tract with a local intercostal block to aid with pain control. [2] All cases were reviewed and demographic data and case details were analyzed. RESULTS: 1000 consecutive aPNL cases were reviewed, identifying 488 men and 512 women, 460 right side and 535 left, mean age 57 years (15-86), mean BMI 30 (15-49), mean ASA of 2.3 (1-4) and mean stone burden 31 mm (4-170), mean fluoroscopy time 84 sec (0-322). Mean OR time was 95 min (32-305) and mean treatment time was 14.9 min (1-262). Mean PACU time was 91 min (37-247). A mini-PNL (mPNL) procedure was conducted in 255 (25.5%) patients. The remaining 745 cases were standard tract size of which 449 were 30Fr and 296 were 24Fr. Stone free rate was 83%. Thirty nine patients had complications ranging from Clavien II-IVa, of which 15 were hospital transfers. CONCLUSIONS: These consecutive 1000 cases may serve as a landmark series demonstrating the feasibility of aPNL. Transitioning PNL to an ambulatory setting is a paradigm shift in the treatment of complex kidney stones. 39 patients experienced complications of Clavien II or higher. Each complication that occurred was managed in an appropriate fashion and the site of service did not lead to an alteration in the outcomes of the adverse events. With an experienced surgeon, well trained operative team and with modifications to the procedure focusing on post-operative pain control, PNL can be safely and effectively performed in a free standing ASC. 1. Davalos JG, Abbott JE. Ambulatory PCNL: Initial Case Series. J Urology. April 20162. Abbott JE, Cicic A, Jump R, Davalos JG. Hemostatic Plug: Novel Technique for Closure of Percutaneous Nephrostomy Tract. J Endourol. March 2015 Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1124-e1125 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information MD Meagan Dunne More articles by this author More articles by this author MD Natalia Ariasvillela More articles by this author DO Joel Abbott More articles by this author MD Julio Davalos More articles by this author Expand All Advertisement Loading ...