All-Seeing-Access Sheath: A Novel Fluoroscopy-Free Placement Technique in Retrograde Intrarenal Surgery

OBJECTIVE: To evaluate the safety and effectiveness of fluoroscopy-free RIRS (Retrograde intrarenal surgery) method in urolithiasis. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Department of Urology, Hitit University Corum Training and Research Hospital, Corum, Turkey, from October 2014 and October 2017. METHODOLOGY: Preoperative and postoperative data of 62 cases of renal calculi that underwent fluoroscopy-free RIRS procedure by a single surgeon were prospectively evaluated. All manipulations were performed with a novel technique; under direct vision during the operation. Fluoroscopy device was kept at hand in the operating room, but was not used. RESULTS: The mean age was found as 51.73 ±12.63 (22-82) years. Fortyone patients (66.1%) were males and 21 (33.9%) were females. The mean size of stones were 19.29 ±7.64 (10-40) mm. The stone-free rate was calculated as 42 (67.7%) cases in a single session one month after the surgery, and 15 (24.2%) cases after the second session at the postoperative first month. A total of 57/61 (91.9%) patients were stone-free after the second procedure. No major intraoperative and postoperative complications were observed. As for the minor complications, one patient (1.6%) developed hematuria and four patients (6.5%) had fever. CONCLUSION: The described fluoroscopy-free RIRS procedure can be performed effectively and safely in patients diagnosed with renal calculi, by endourologists.