Dr. Guido Giusti

Simultaneous Bilateral Endoscopic Surgery

Urolithiasis is a common health disorder in the Western World with a lifetime risk of stone formation as high as 10– 12% in males and 6–8% in females and the prevalence of stone disease is on the rise over the past two decades. Similarly, also the incidence of bilateral renal stones is not negligible—recent studies have shown that up to 15% of patients with urolithiasis will have bilateral renal stones. It has been demonstrated that bilateral same-session endourological procedures for stones are effective in terms of both efficacy (i.e., stone-free rate or SFR) and safety. Moreover, same-session bilateral procedures for nephrolithiasis are associated with several advantages, including single anesthetic exposure for the patient, shorter cumulative hospitalization time, fewer days out of work, decreased patient radiation exposure, and greater overall cost effectiveness. Historically, same-session bilateral procedures have been performed by the surgeon first completing the treatment on one side and then completing the treatment on the other side—that is, treating the stones in the right ureter and/or kidney first, and then proceeding with treatment of the left ureter and/or kidney or vice versa. However, a potentially more efficient treatment option is simultaneous bilateral endoscopic surgery (SBES), which entails at least two surgeons working simultaneously, each treating one kidney or ureter as opposed to treating one kidney after the other. Potential advantages would include improvements in efficiency—treatment of both renal units with shorter anesthetic time and also a decrease in the total number of procedures that a given patient may require. To date, there are sparse reports in the literature on the safety and efficacy of SBES. Herein, we demonstrate a case of SBES for bilateral renal stones.

With Boston Scientific