TAIPEI, TAIWAN (UroToday.com) - At the World Congress of Endourology meeting in Taipei, Bard Urology sponsored an international conference on ultrasound-guided PCNL.
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The conference, designed to debate the merits of ultrasound guidance versus more traditional fluoroscopy-guided PCNL, was well attended by over 80 international delegates at the meeting. Translated into both English and Chinese, the meeting was a wonderful international collaboration. The international distinguished faculty included Dr. Marshall Stoller (USA), Dr. Li Jianxing (China), Dr. Jaime Landman (USA), Dr. Tom Chi (USA), and Dr. Yeong-Chin Jou (Taiwan).
The keynote speaker was Dr. Li from China who has perhaps the world’s most robust experience with ultrasound guided PCNL. Dr. Li reviewed his technique in great detail, and the high-quality video was a tribute to his remarkable expertise. He was able to share tips and tricks and discuss the equipment which he uses. Dr. Li also reviewed his extensive database from the 15 000-patient experience. His high stone-free rate and low complication rate highlighted some of the advantages of the ultrasound-guided approach. Dr. Li also reviewed his extensive experience with pediatric PCNL.
After Dr. Li’s presentation, Dr. Chi presented on the advantages and merits of the more standard fluoroscopy-guided approach. These two lectures served as an outstanding platform for debate on the advantages and disadvantages of each approach. The debate included the expert panel as well as robust contributions from the audience which included Dr. Roger Sur from the University of California, San Diego. In the end, while the majority of the audience currently uses fluoroscopy, it was clear that there were some advantages to ultrasound-guided PCNL and there seemed to be great interest from the audience in exploring this technique more.
Dr. Landman, Chair of the Department of Urology from the University of California, stated that, “it is currently estimated that up to 1.5 to 2% of malignancies in the U.S are derived from medical imaging. As such, the use of ultrasound, either as a primary imaging modality or as a complement to fluoroscopy for PCNL procedures, is very appealing.” Dr. Landman and the team from UC Irvine currently perform their PCNL procedures with both ultrasound and fluoroscopy guidance, but are planning a prospective randomized study in this regard.
Of note, there was very vigorous and energetic debate between Dr. Stoller and Dr. Landman regarding the use of direct vision (ureteroscopic guided) PCNL versus standard direct access. Dr. Stoller felt strongly that the use of the ureteroscope extended operating time without significant benefit. In contrast, Dr. Landman contended that the procedure was made much more precise and increased safety.
The final conclusions of the meeting were that there are benefits to both the ultrasound-guided and fluoroscopy-guided approaches, and that more study was needed to better understand these two techniques.
Click HERE to watch the presentation by Dr. Li Jianxing
Presented at the 32nd World Congress of Endourology & SWL - September 3 - 7, 2014 - Taipei, Taiwan
Written by Adam Kaplan, MD, chief resident, Department of Urology, School of Medicine, University of California-Irvine, and medical writer for UroToday.com