Impact of Surgical Position on Stone-Free Rates in Retrograde Intrarenal Surgery
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: The T-Tilt position.
- Who it may be relevant to
- Registry conditions: Stone, Kidney, Stones, Kidney, Stone;Renal. Basic parameters: from 18 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- Turkey (Türkiye)
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Does the Positioning in Retrograde Intrarenal Surgery Affect Stone-Free Rates? A Prospective Randomized Controlled Trial
Overview
The goal of this clinical trial is to determine whether the surgical position during retrograde intrarenal surgery (RIRS) affects stone-free rates in adults with kidney stones. The main questions it aims to answer are: * Does the modified lithotomy position result in a higher stone-free rate compared to the standard lithotomy position? * Are there differences in complication rates between the two surgical positions? Researchers will compare patients undergoing RIRS in the standard lithotomy position to those in the modified lithotomy position (30-degree Trendelenburg with elevated surgical side) to assess its impact on stone clearance and surgical outcomes. Participants will: * Be randomly assigned to one of two surgical positions * Undergo RIRS with standard surgical procedures * Have follow-up imaging to assess stone clearance after surgery This study aims to improve surgical techniques and patient outcomes in kidney stone treatment.
Interventions
- Procedure The T-Tilt position
The T-Tilt position is a modified lithotomy position used during retrograde intrarenal surgery (RIRS). In this position: The patient is placed in a 30-degree Trendelenburg position, meaning the head is slightly lower than the feet. The surgical side is elevated at a 30-degree angle to improve access to the kidney. This modified positioning is designed to enhance stone clearance, particularly by facilitating the movement of stone fragments away from the lower kidney calyces, where residual sto
Primary outcome measures
- Stone-Free Rate After Retrograde Intrarenal Surgery [Time frame: 6 weeks post-surgery]
Secondary outcome measures (1)
- Postoperative Complication Rate [Time frame: Within 30 days post-surgery]
Eligibility criteria
Inclusion criteria
- Presence of single or multiple kidney stones, with the largest stone ≤2 cm
- Age ≥18 years
- Provided written informed consent to participate in the study
- Indicated for retrograde intrarenal surgery (RIRS) as a treatment approach
Exclusion criteria
- Severe cardiovascular disease (e.g., heart failure)
- Congenital kidney anomalies (e.g., horseshoe kidney, ectopic kidney)
- Concurrent ureteral stones
- Pregnancy or planning pregnancy
- History of previous kidney surgery on the same side
- Active urinary tract infection (UTI)
- Coagulopathy or use of anticoagulant therapy that cannot be stopped before surgery
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: No
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Triple blind
- Primary purpose
- Treatment
Study locations
Turkey (Türkiye) · 1 center
- Ondokuz Mayıs University — Samsun
Publications
- Canakci C, Dincer E, Can U, Coskun A, Otbasan BK, Ozkaptan O. The relationship between stone-free and patient position in retrograde intrarenal surgery: a randomized prospective study. World J Urol. 2024 May 9;42(1):308. doi: 10.1007/s00345-024-05013-1. PMID 38722376
- Liaw CW, Khusid JA, Gallante B, Bamberger JN, Atallah WM, Gupta M. The T-Tilt Position: A Novel Modified Patient Position to Improve Stone-Free Rates in Retrograde Intrarenal Surgery. J Urol. 2021 Nov;206(5):1232-1239. doi: 10.1097/JU.0000000000001948. Epub 2021 Jul 12. PMID 34251886
Identifiers
NCT: NCT06809582 · B.30.2.ODM.0.20.08/603-670