Technique for supine percutaneous nephrolithotomy

Percutaneous nephrolithotomy is the gold standard for large kidney stones. Supine approach has proved to be safe and effective. Herein we present an educational video about our stepwise technique of supine PCNL in a safe way

Aspetti epidemiologici della calcolosi di calcio in Italia: distribuzione dei fenotipi intermedi nella popolazione italiana

n/

Italian endourological panorama: results from a national survey

Introduction: The purpose of this survey was to explore the dissemination of flexible ureteroscopy (fURS), shockwave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL) in the Italian urological community and to know the real availability of the complex endourological armamentarium all over the country.Materials and methods: An online questionnaire characterizing the case volume/year of upper urinary tract stone treatment and the availability of flexible ureteroscopes (FUs) armamentarium was sent to all urological Italian centers.Results: The survey was sent to 294 urological centers and 146 responded (49.7%). The case volume/year of fURS was the following: &lt;20 cases in 20 centers (13.7%); 20-50 cases in 40 centers (27.4%), &gt;50- &lt;100 cases in 55 centers (37.8%) and &gt;100 cases in 28 centers (19.2%). The case volume/year of SWL was the following: &lt;50 cases in 18 centers (12.3%); &gt;50- &lt;200 cases in 56 centers (36.4%) and &gt;200 cases in 35 centers (24%). In 37 centers (25.3%) SWL was not utilized at all. The case volume/year of PCNL was the following: &lt;10 cases in 20 centers (14%); &gt;10 - &lt;30 cases in 55 centers (30%), &gt;30- &lt; 50 cases in 33 centers(23%), &gt;50- &lt;100 cases in 13 centers (9%) and &gt;100 procedures in 2 centers (1%). However, 24 centers (16%) did not perform any PCNL procedure.Four centers (3%) did not have any FU at the moment of the survey. The availability of FUs was as follows: 1 FU in 21 (14%) centers, 2 FUs in 61 (42%) centers, 3 FUs in 29 (20%) centers, 4 FUs in 13 (9%) centers and ≥5 FUs in 16 (9%) centers. Only 82 (56%) centers had all of their FUs in working condition.Conclusions: This survey succeeded in providing a complete overview on the Italian endourological panorama.</p

Hospital care in Departments defined as COVID-free: A proposal for a safe hospitalization protecting healthcare professionals and patients not affected by COVID-19

The COVID-19 pandemic influenced the normal course of clinical practice leading to significant delays in the delivery of healthcare services for patients non affected by COVID-19. In the near future, it will be crucial to identify facilities capable of providing health care in compliance with the safety of healthcare professionals, administrative staff and patients. All the staff involved in the project of a Covid-free hospital should be subjected to a diagnostic swab for COVID-19 before the beginning of healthcare activity and then periodically in order to avoid the risk of contamination of patients during the process of care. The modifications of various activities involved in the process of care are described: outpatient care, reception of inpatients, inpatient ward and operating room. For outpatient care, modality of appointment procedure, characteristics of waiting room and personal protective equipment (PPE) for healthcare professionals and administrative staff are presented. Reception of inpatients shall be conditional on a negative swab for COVID-19 obtained with a drive-in procedure. The management of the operating room represents the most crucial step of the patient's care process. The surgical team should be restricted and monitored with periodic swabs; surgical procedures should be performed by experienced surgeons according to standard procedures; surgical training experimental treatments and research protocols should be suspended. Adequate personal protective equipment and measures to reduce aerosolization in the operating room (closed circuits, continuous cycle insufflators, fume extraction) should be adopted. Prevention of possible transmission of the virus during procedures in open, laparoscopic and endoscopic surgery is to use a multi-tactic approach, which includes correct filtration and ventilation of the operating room, the use of appropriate PPE (FFP3 plus surgical mask and protective visor for all the staff working in the operating room) and smoke evacuation devices with a suction and filter system