Adopting ultrasound guided PCNL in nephrolithiasis management

Abstract

Introduction: This study aimed to evaluate the learning curve associated with the adoption of US guided PCNL and demonstrate that it can be carried out safely with results comparable to those obtained using standard PCNL. Methods: Prospective study with 65 patients who underwent PCNL between 2019 and 2020. all procedures were performed in supine position and an initial attempt to gain access to the kidney using US was made. Results: Mean procedure duration was 69.5 ± 27.8 min. Fluoroscopy was used with a mean dose of 276.68 ± 560.71 (cGycm3) and mean fluoroscopy time 40.25 ± 77.69 (s). Throughout the study there was a steady decrease in the use of fluoroscopy and amount of radiation to gain access to the kidney to only 25% at the study end. 76.5% of the patients were stone free at follow-up. Complication rate was 9.2%. Conclusions: Fluoroless US guided PCNL is safe, feasible and reproducible procedure.