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comparison among the various miniaturized PCNL types.
We need to standardize the terminology and methodology
used to assess stone-free rates to avoid confusion in the
contemporary literature. This in turn would facilitate
acquisition of robust data for the future.
Radiation is a concern for the majority of endourologic
procedures. In a study recently conducted at our center, we
found an inverse relation between radiation exposure
and the sheath size used. The mean radiation exposure
to the surgeon was 0.29 [4_TD$DIFF]0.12 mSv, 0.18 [5_TD$DIFF]0.1 mSv,
0.16 [6_TD$DIFF]0.08 mSv, and 0.11 0.04 [7_TD$DIFF] mSv for an average sheath
size of 26.5 1.6 Fr (standard PCNL), 21.2 1.7 Fr (miniperc),
10.7 0.6 Fr (MIP Xs, Karl Storz GmBH), and 4.5 Fr (microperc;
Polydiagnost GmBH), respectively. This suggests that smaller
tract sizes have a potential to reduce radiation exposure to the
surgeon, which of course needs to be validated in further
studies.
Innovative ideas, techniques, and technology will
continue to evolve further in the future. The benchmark
for assessing the efficacy of any endourologic procedure is
to ascertain the complication rates, stone clearance rates,
and the need for ancillary procedures In this regard, the
three ‘‘new kids on the block’’ namely miniperc, ultra-
miniperc, and microperc, need to undergo the rigors of
prospective randomized comparative studies to prove their
worth.
Conflicts of interest: The authors have nothing to disclose.
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