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01-09-2021 | Original Article

Simplified biplanar (0–90°) fluoroscopic puncture technique for percutaneous nephrolithotomy: the learning curve

Authors: B. O. Manzo, J. E. Torres, J. D. Cabrera, E. Lozada, E. Emiliani, F. Sepulveda, C. Morales, I. Morales, H. M. Sanchez

Published in: World Journal of Urology | Issue 9/2021

Abstract

Purpose

To evaluate the learning curve of the simplified fluoroscopic biplanar (0–90º) puncture technique for percutaneous nephrolithotomy.

Methods

We prospectively evaluated patients with renal stones treated with percutaneous nephrolithotomy by a single institution’s fellows employing the simplified bi-planar (0–90º) fluoroscopic puncture technique for renal access. The learning curve was assessed with the fluoroscopic screening time and the percutaneous renal puncture time. Data obtained were compared to a subset of patients operated by a senior surgeon.

Results

Eighty-nine patients were included in the study. Forty patients were operated by fellow-1, 39 by fellow-2, and 10 patients by the senior surgeon.

Demographic data of all patients between groups were homogeneous, with no difference in gender (p = 0.432), age (p = 0.92), stone volume (p = 0.78), puncture laterality (p = 0.755), and body mass index (p = 0.365). The mean puncture time was 7.5, 4, and 3.1 min for fellow-1, fellow-2, and expert, respectively. The mean fluoroscopic screening time for the puncture was 10, 11, and 5.1 s for fellow-1, fellow-2, and the expert, respectively. Stone cases, both fellows needed to complete 10 procedures to match the senior surgeon in the mean puncture time (p = 0.046); meanwhile, the fluoroscopic screening time was equal even before to complete 10 procedures.

Conclusion

This study suggests that with the simplified biplanar (0–90º) puncture technique, the fluoroscopic screening time used in the learning process is brief. A novice fellow could require to complete ten cases to flatten the learning curve treating complex stone cases, and a flat learning curve is seen since the beginning when treating simple renal stones.

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Title: Simplified biplanar (0–90°) fluoroscopic puncture technique for percutaneous nephrolithotomy: the learning curve
Authors: B. O. Manzo
J. E. Torres
J. D. Cabrera
E. Lozada
E. Emiliani
F. Sepulveda
C. Morales
I. Morales
H. M. Sanchez
Publication date: 01-09-2021
Publisher: Springer Berlin Heidelberg
Published in: World Journal of Urology / Issue 9/2021
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI: https://doi.org/10.1007/s00345-021-03669-7

At a glance: The STEP trials

Springer Medicine

Simplified biplanar (0–90°) fluoroscopic puncture technique for percutaneous nephrolithotomy: the learning curve

Abstract

Purpose

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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