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Abstract
Abdominal taping and impact on skin to stone distance in supine percutaneous nephrolithotomy
Non-Moderated Poster Abstract
Clinical Research
Endourology: Urolithiasis
Author's Information
7
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Singapore
Lynnette RL Tan lynnette.trl@gmail.com Tan Tock Seng Hospital Urology Singapore Singapore *
Soon Hock Koh lynnette.trl@gmail.com Tan Tock Seng Hospital Urology Singapore Singapore -
Bryan Tan lynnette.trl@gmail.com National University of Singapore Yong Loo Lin School of Medicine Singapore Singapore -
Yuyi Yeow lynnette.trl@gmail.com Advanced Urology Associates Urology Singapore Singapore -
Keller Etienne Xavier lynnette.trl@gmail.com University Hospital Zurich Urology Zurich Switzerland -
Yee Mun Lee lynnette.trl@gmail.com Nexus Surgical Associates Urology Singapore Singapore -
Jia-Lun Kwok lynnette.trl@gmail.com Tan Tock Seng Hospital Urology Singapore Singapore -
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Abstract Content
Supine percutaneous nephrolithotomy (PCNL) is increasingly practised worldwide. Skin to stone distance is usually greater in this position compared to prone PCNL. Thick abdominal folds and fat may make percutaneous access more challenging especially in supine PCNL with ultrasound. Taping the abdomen brings the skin folds and subcutaneous layers away from the flank, arguably making the skin taut to facilitate ultrasound guided access. This technique has been described in literature, especially in patients with higher Body Mass Index (BMI). Our objective is to evaluate the impact of abdominal taping on skin to stone distance (SSD).
Patients listed for supine PCNL from 29th June 2021 to 21st May 2024 were prospectively recruited. All were positioned in the Modified Galdakao−Valdivia position, with abdominal taping. SSD was measured with ultrasound pre and post taping at the intended access site by the same surgeon, ensuring uniform visualization of the kidney (coronal view) and stone. The change in pre and post taping SSD was calculated.
75 patients were recruited (Male 64%). Median age was 64 years (IQR 54 to 70), body mass index (BMI) 25.3 (Min=18.1, Max=47.3, IQR 22.2 to 27.6), and weight 67kg (IQR 58 to 77). Pre taping SSD significantly correlated with weight (R2=0.22, p<0.001) and BMI (R2=0.18, p<0.001). There was a significant effect of abdominal taping on pre and post taping SSD (mean of differences 1.4mm, SD 5.2, p=0.02). 63% of patients had a positive change in SSD from taping (i.e. longer SSD). Change in SSD from taping did not correlate with BMI, height or weight (all p>0.05). Subgroup analysis showed no difference in change of SSD between BMI <25 vs ≥25, or <30 vs ≥30 subgroups (p=0.75 and 0.39, respectively).
Our results suggest that abdominal taping affects SSD in supine PCNL. In some patients, this can result in increased SSD. Pre taping SSD is longer with heavier weight and higher BMI. Future studies should further explore the change in SSD from taping in a patient group with a higher proportion of obese BMI.
Urology, Endourology, Urolithiasis, Percutaneous Nephrolithotomy, Techniques, Abdominal Taping
 
 
 
 
 
 
 
 
 
 
2054
 
Presentation Details