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METHODS article

Front. Surg.

Sec. Genitourinary Surgery and Interventions

Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1706729

Ultrasound-Guided Percutaneous Nephrolithotomy Without Fluoroscopy: Early Surgical Experience with Video-Based Technical Insights

Provisionally accepted
Chenghao  TanChenghao TanXin  LiXin LiXiaochun  ZhangXiaochun ZhangGang  WangGang Wang*Gengyan  XiongGengyan Xiong*
  • Peking University First Hospital Department of Urology, Beijing, China

The final, formatted version of the article will be published soon.

Objectives: To assess the feasibility, safety, and short-term outcomes of ultrasound-guided percutaneous nephrolithotomy (PCNL) performed by a single early-career urologist without fluoroscopic guidance. Methods: We retrospectively analyzed 70 consecutive ultrasound-guided PCNL cases performed independently by a single early-career urologist at Peking University First Hospital. All procedures employed single-tract, rigid ureteroscopy-assisted access under real-time ultrasound guidance without fluoroscopy. Perioperative parameters included access success, operative time, hemoglobin drop, stone-free rate, and complications. An accompanying educational video was included to facilitate reproducibility. Results: The stone-free rate after a single procedure was 75.7%, rising to 88.6% at 6-month follow-up. No major complications occurred. The mean stone size was 2.22 cm. Mean access time was 9 minutes. Access was successfully achieved in all cases. These outcomes were achieved despite the surgeon's early learning curve, reflecting a high degree of technical feasibility and safety under structured mentorship. Conclusions: Ultrasound-guided PCNL is a safe, effective, and radiation-free alternative to fluoroscopy-guided procedures. It can be reliably adopted early in surgical practice. The accompanying video supports broader understanding and dissemination of this radiation-free approach, especially in resource-limited or high-volume centers.

Keywords: Ultrasound-guided, Percutaneous nephrolithotomy, Radiation-free, Video-based, technical insights

Received: 16 Sep 2025; Accepted: 20 Oct 2025.

Copyright: © 2025 Tan, Li, Zhang, Wang and Xiong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Gang Wang, drwanggang@163.com
Gengyan Xiong, xgy6205@gmail.com

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