Abu Dhabi, United Arab Emirates (UroToday.com) Dr. Meagan Dunne began by introducing the premise of her study: percutaneous nephrolithotomy (PCNL) is traditionally performed in the hospital with at least overnight observation. Same-day discharge has not been widely adopted, with one of the first reports of ambulatory outpatient care of PCNL patients published as late as 2016.1 Dr. Dunne and her colleagues sought to report their experience with ambulatory PCNL and determine if it is a feasible procedure to perform in the outpatient setting at a free-standing ambulatory surgical center (ASC). 

The team retrospectively reviewed 550 patients who underwent PCNL at the ASC between 2015 and 2019. All PCNLs were performed by two surgeons and the same operative team. A 30Fr sheath was used 73% of the time and a 17Fr (mini-PCNL) was used 21%; the remaining 6% were 24Fr. Factors that aided in same-day discharge included operative surgeon obtaining renal access, fluoroscopic or endoscopic guided access, “tubeless” access (i.e. stent without nephrostomy tube), hemostatic plugging of the access tract, and local anesthetic intercostal block before the procedure for pain management. Of the 550 patients, 21 (6%) had complications, with 13 patients (2.4%) ultimately requiring transfer to an inpatient hospital. The stone-free rate in the cohort was 86%.

Dr. Dunne had a few take-home points. Firstly, PCNL can be safely performed in an ASC with same-day discharge. Procedural modifications such as intercostal block enhanced safety and addressed post-operative pain. 


Presented by: Meagan M. Dunne, MD, University of Maryland Medical Center, Chesapeake Urology and University of Maryland BWMC, ‎‎Glen Burnie, Maryland

Written by: Lillian Xie, BA, Department of Urology, University of California, Irvine, California, at the 37th World Congress of Endourology (WCE) – October 29th-November 2nd, Abu Dhabi, United Arab Emirates
1. Davalos JG, Abbott JE. Ambulatory PCNL: Initial CaseSeries. J Urology. April 2016. Vol. 195 (4), Supplement1: MP51-20, e688-e689.