This study aims to evaluate Under Vision Total Tubeless PCNL (TT-PCNL) as a novel technique in reducing surgeon exposure to X-rays compared to the standard Total Tubeless PCNL. Percutaneous nephrolithotomy (PCNL) has been widely welcomed as a less-invasive medication for kidney stones. However, because it is usually performed using fluoroscopy, the endourologist is at risk of chronic X-ray exposure.

The number of 76 consecutive patients who were candidates for PCNL surgery was randomized into two groups: 38 patients experienced TT-PCNL, and 38 patients underwent Under Vision TT-PCNL. The results were compared with fluoroscopy time and surgeon satisfaction.

The fluoroscopy time in the Under Vision TT-PCNL group was lower than in the Total Tubeless PCNL group (0.02). Surgeon satisfaction was higher in the Under Vision Total Tubeless PCNL group than in the TT-PCNL group (P-value=0.001). The mean total duration of surgery in the TT-PCNL under the Vision group was lower than the Total Tubeless PCNL group (P-value=0.04). There was no significant difference between the two groups' complications.

The Under Vision TT-PCNL is compared to the normal PCNL in safety and effectiveness, but also it can significantly reduce the use of a fluoroscope. Moreover, surgeon satisfaction is better compared to the standard technique.