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Introduction <p>The ergonomic aspects of retrograde intrarenal stone surgery (RIRS) remain underexplored, despite their crucial role in minimizing musculoskeletal strain among surgeons and enhancing procedural efficiency. This study introduces a novel “Gun-holding” surgical posture for RIRS, aiming to improve surgeons’ physical well-being and extend their operative careers.</p> Materials and methods <p>From July 2023 to June 2024, a total of 60 patients were prospectively enrolled from an initial pool of 104 and were randomized into two groups: the “Gun-holding” surgical posture group (Group A, <i>n</i> = 30) and the conventional surgical posture group (Group B, <i>n</i> = 30). Patient demographics, clinical outcomes, ergonomic assessments, and torque analysis for surgeons were analyzed.</p> Results <p>Baseline characteristics and stone burden were comparable between the two groups. Torque analysis demonstrated a higher upper limb torque ratio in Group A compared to Group B. Ergonomic evaluation revealed a significant advantage for Group A (total score: 16.1 ± 4.1 vs. 22.4 ± 9.1, <i>P</i> = 0.001). Group A also had a significantly shorter mean hospitalization duration (1.7 ± 0.9 days vs. 2.9 ± 1.9 days, <i>P</i> = 0.003). Although the mean operative time for Group A was shorter (49.9 ± 26.1&#xa0;min vs. 63.0 ± 40.4&#xa0;min), this difference was not statistically significant (<i>P</i> = 0.139). No significant differences were observed in initial stone-free status (SFS), 3-month SFR, postoperative Day 1 hemoglobin drop, or overall complication rates.</p> Conclusion <p>The “Gun-holding” surgical posture is a feasible, efficient, and safe alternative for performing RIRS, offering significant ergonomic benefits to surgeons.</p>

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“Gun-holding” surgical posture versus conventional surgical posture in flexible ureteroscopy: a prospective randomized study

  • 期刊论文

  • 发表日期：

    2025年9月26日

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  • Xiaomin Gao,
  • Chaoyue Lu,
  • Qing Chen,
  • Lianguo Chen,
  • Siyu Zhuo,
  • Jianyu Chen,
  • Tianle Zheng,
  • Binhao Du,
  • Fangyi Zhang,
  • Zhixian Yu,
  • Wei Chen,
  • Xiaofeng Gao,
  • Weifang Sun,
  • Fanggui Shao,
  • Yeping Li

摘要

Introduction

The ergonomic aspects of retrograde intrarenal stone surgery (RIRS) remain underexplored, despite their crucial role in minimizing musculoskeletal strain among surgeons and enhancing procedural efficiency. This study introduces a novel “Gun-holding” surgical posture for RIRS, aiming to improve surgeons’ physical well-being and extend their operative careers.

Materials and methods

From July 2023 to June 2024, a total of 60 patients were prospectively enrolled from an initial pool of 104 and were randomized into two groups: the “Gun-holding” surgical posture group (Group A, n = 30) and the conventional surgical posture group (Group B, n = 30). Patient demographics, clinical outcomes, ergonomic assessments, and torque analysis for surgeons were analyzed.

Results

Baseline characteristics and stone burden were comparable between the two groups. Torque analysis demonstrated a higher upper limb torque ratio in Group A compared to Group B. Ergonomic evaluation revealed a significant advantage for Group A (total score: 16.1 ± 4.1 vs. 22.4 ± 9.1, P = 0.001). Group A also had a significantly shorter mean hospitalization duration (1.7 ± 0.9 days vs. 2.9 ± 1.9 days, P = 0.003). Although the mean operative time for Group A was shorter (49.9 ± 26.1 min vs. 63.0 ± 40.4 min), this difference was not statistically significant (P = 0.139). No significant differences were observed in initial stone-free status (SFS), 3-month SFR, postoperative Day 1 hemoglobin drop, or overall complication rates.

Conclusion

The “Gun-holding” surgical posture is a feasible, efficient, and safe alternative for performing RIRS, offering significant ergonomic benefits to surgeons.