Risk of radiation exposure during PCNL

Fluoroscopic guidance is a routine practice in endourology; both the physician and the assistances are exposed to some radiation via radiation scatter. Measurement of radiation doses in staff is important, but often these data are not reported. We measured radiation exposure during 100 cases of percutaneous nephrolithotomy using lithium fluoride thermoluminescent dosimeters placed at the head, eye glasses, the fingers, and the legs of the operating surgeon, the assistant, and the circulating nurse. The mean screening time was 4.5 minutes [range, 1 to 8 minutes] with mean fluoroscopy tube potential of 73 kVp, and mean tube current of 2.8 mA. The estimated scatter exposure rate at 40 cm from the x-ray beam was 0.47, 0.04, 0.21, and 4.1 micro Gy to the head, eye glasses, the fingers, and the legs of the operating surgeon, respectively. The estimated scatter exposure rate at different points from the x-ray beam was 0.05, 0.01, 0.025, and 0.1 micro Gy to the head, eye glasses, the fingers, and the legs of the assistant, respectively and the estimated scatter exposure rate at all different points from the x-ray beam for circulating nurse was 0 micro Gy. Fluoroscopic screening results in radiation exposure of the medical staff. The surgeon received the maximum radiation exposure, mostly to the legs and very least to the eyes. The assistant received less radiation exposure than the surgeon and the nurse did not receive significant amount of radiation

Laparoscopic adrenalectomy ten-year experience, 67 procedures

The purpose of this study was to evaluate the short-term and long-term results of laparoscopic adrenalectomies carried out in our center. A total of 67 laparoscopic adrenalectomies were performed during the 10 years between 1995 and 2005 at Shahid Labbafinejad Medical Center. A transperitoneal lateral approach was used in 65 [97.0%] of the patients, and retroperitoneal approach was used in 2 [3.0%]. The clinical characteristics and the outcomes were reviewed in a retrospective study. Indications for laparoscopic adrenalectomy in our patients were as follows: pheochromocytoma in 28 patients [41.8%], aldosterone-producing adenoma in 15 [22.4%], pseudocyst in 6 [9.0%], Cushing syndrome [macronodular adrenocortical hyperplasia] in 5 [7.5%], nonfunctioning adenoma [incidentaloma] in 5 [7.5%], myelolipoma in 2 [3.0%], almost normal adrenal tissue in 2 [3.0%], adrenal cyst in 2 [3.0%], adenocarcinoma in 1 [1.4%], and schwannoma in 1 [1.4%]. The mean operative time for unilateral cases was 149.0 A +/- 36.1 minutes. The mean intraoperative blood loss was 126 A +/- 36 mL. Conversion rate to open surgery was 7.5%. Reoperation due to hemorrhage was performed in 1 patient. Laparoscopic adrenalectomy is a safe procedure in some adrenal tumors and a reasonable option for selected large adrenal tumors when complete resection is technically feasible and there is no evidence of local invasion