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Percutaneous Nephrolithotomy in the Modified Flank Free Supine Position: An Observational Prospective Study to Identify the Surgeon’s Learning Curve

Article

Last updated: 04 Jan 2025

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Subjects

-

Tags

Surgery

Abstract

Background: Percutaneous nephrolithotomy was usually practiced in prone position. However, there is a recent shift towards supine position. This shift needs a continuous practice to increase the surgeon's learning curve.
Aims: To give an insight into the learning curve of a single surgeon, capable of doing percutaneous nephrolithotomy in the conventional prone position, during his transition to the supine one using different indicators.
Materials and Methods: This study included 80 procedures, equally divided into 4 groups and the following endpoints were recorded and compared among groups: operation and fluoroscopic screening times, volume of the irrigant fluid consumed, postoperative length of hospital stay, stone clearance rate and procedure related morbidity.
Results: The mean operation and fluoroscope screening durations showed a statistically significant decline with time. The operative time drop from 117 minutes at the beginning to about the half [60 minutes] after sixth months and working with 80 patients. The fluoroscopy time declined from 3.5 minutes at the beginning to 1.5 minute at the end. Our stone clearance rate continued to improve among groups [with advancement of learning curve] [P = 0.034] without approaching the plateau. Also for other indicators [volume of the irrigant fluid consumed, postoperative length of hospital stay and complications], all showed statistical significant reduction with increased learning curve [P < 0.0001].
Conclusions: Operative time and stone clearance rate continued improvement with increasing learning curve. However, the volume of irrigation fluid, rate and grade of complications and length of postoperative stay reached its plateau after 40 procedures.

DOI

10.21608/ijma.2020.39468.1156

Keywords

Conventional Prone Position, Learning curve, Modified Flank Free Supine Position, percutaneous nephrolithotomy, Urinary Stones

Authors

First Name

Ahmed

Last Name

Abdel Gawad

MiddleName

M.

Affiliation

Department of Urology, Al-Azhar Faculty of Medicine (Males), District II, New Damietta City, Damietta Governate, Egypt.

Email

aa.urology@domazhermedicine.edu.eg

City

Talkha

Orcid

0000-0001-7051-6019

First Name

Ahmed

Last Name

Aboelsaad

MiddleName

Yousef

Affiliation

Urology Department, Faculty of Medicine (Damietta), Al-Azhar University

Email

aboelsaadurology@hotmail.com

City

Man

Orcid

0000-0001-9851-8120

Volume

3

Article Issue

1

Related Issue

21557

Issue Date

2021-01-01

Receive Date

2020-08-16

Publish Date

2021-01-01

Page Start

1,060

Page End

1,068

Print ISSN

2636-4174

Online ISSN

2682-3780

Article File

IJMA_Volume 3_Issue 1_Pages 1060-1068.pdf

PDF . 1.8MB

Link

https://ijma.journals.ekb.eg/article_122428.html

Detail API

https://ijma.journals.ekb.eg/service?article_code=122428

Order

22

Type

Original Article

Type Code

816

Publication Type

Journal

Publication Title

International Journal of Medical Arts

Publication Link

https://ijma.journals.ekb.eg/

MainTitle

Percutaneous Nephrolithotomy in the Modified Flank Free Supine Position: An Observational Prospective Study to Identify the Surgeon’s Learning Curve

Details

Type

Article

Created At

22 Jan 2023