RecruitingNot ApplicableNCT06809582

Impact of Surgical Position on Stone-Free Rates in Retrograde Intrarenal Surgery

Does the Positioning in Retrograde Intrarenal Surgery Affect Stone-Free Rates? A Prospective Randomized Controlled Trial

Sponsor

Ondokuz Mayıs University

Enrollment

128 participants

Start Date

Jan 1, 2025

Study Type

INTERVENTIONAL

Conditions

Stones, Kidney Stone, Kidney Stone;Renal

Summary

The goal of this clinical trial is to determine whether the surgical position during retrograde intrarenal surgery (RIRS) affects stone-free rates in adults with kidney stones. The main questions it aims to answer are: * Does the modified lithotomy position result in a higher stone-free rate compared to the standard lithotomy position? * Are there differences in complication rates between the two surgical positions? Researchers will compare patients undergoing RIRS in the standard lithotomy position to those in the modified lithotomy position (30-degree Trendelenburg with elevated surgical side) to assess its impact on stone clearance and surgical outcomes. Participants will: * Be randomly assigned to one of two surgical positions * Undergo RIRS with standard surgical procedures * Have follow-up imaging to assess stone clearance after surgery This study aims to improve surgical techniques and patient outcomes in kidney stone treatment.

Eligibility

Min Age: 18 Years

Inclusion Criteria4

Presence of single or multiple kidney stones, with the largest stone ≤2 cm
Age ≥18 years
Provided written informed consent to participate in the study
Indicated for retrograde intrarenal surgery (RIRS) as a treatment approach

Exclusion Criteria7

Severe cardiovascular disease (e.g., heart failure)
Congenital kidney anomalies (e.g., horseshoe kidney, ectopic kidney)
Concurrent ureteral stones
Pregnancy or planning pregnancy
History of previous kidney surgery on the same side
Active urinary tract infection (UTI)
Coagulopathy or use of anticoagulant therapy that cannot be stopped before surgery

Print for Your Doctor

Interested in this trial?

Get notified about updates and connect with the research team.

Interventions

PROCEDUREThe T-Tilt position

The T-Tilt position is a modified lithotomy position used during retrograde intrarenal surgery (RIRS). In this position: The patient is placed in a 30-degree Trendelenburg position, meaning the head is slightly lower than the feet. The surgical side is elevated at a 30-degree angle to improve access to the kidney. This modified positioning is designed to enhance stone clearance, particularly by facilitating the movement of stone fragments away from the lower kidney calyces, where residual stones often remain. Researchers will compare this position to the standard lithotomy position to determine its impact on stone-free rates and surgical outcomes.