Hein S, Schoenthaler M, Wilhelm K, et al. Ultralow Radiation Exposure During Flexible Ureteroscopy in Patients With Nephrolithiasis-How Far Can We Go? Urology. 2017 Oct;108:34-39.

To evaluate the feasibility and clinical performance of a novel surgeon technique and protocol targeting ultralow fluoroscopy usage in retrograde intrarenal surgery (RIRS). All RIRS procedures between 2009 and 2015 for 10- to 20-mm renal calculi performed by the same 2 experienced urologists were eligible. All procedures were performed using a highly standardized step-by-step RIRS technique. This technique was modified by the ultralow radiation exposure RIRS protocol; herein, as much as possible of the standardized steps were performed without radiation control targeting ultralow fluoroscopy usage. Primary end points were fluoroscopy time and dose area product.

Hassan AE, Amelot S. Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience. Interventional Neurology. 2017 Oct;6(3-4):105-116.

We evaluated patient exposure to radiation during common neurointerventions performed with a recent flat-panel detector angiographic system and compared our results with those of recently published studies.The DAP (Gy × cm2), fontal and lateral CAK (Gy), FT (min), and total number of DSA frames were as follows: 43 (33–60), 0.26 (0.19–0.33), 0.09 (0.07–0.13), 5.6 (4.2–7.5), and 245 (193–314) for diagnostic cerebral angiographies, and 66 (41–110), 0.46 (0.25–0.80), 0.18 (0.10–0.30), 18.3 (9.1–30.2), and 281 (184–427) for interventions.

Hartmann J, Distler F, Baumuller M, et al. Risk of Radiation-Induced Cataracts: Investigation of Radiation Exposure to the Eye Lens During Endourologic Procedures. J Endourol. 2018 Oct;32(10):897–903.

The aim of the study was to analyze real radiation exposure to the eye lens of the urologist during various interventions, during which the patient is in the lithotomy position. The correlation between DAP and the apron dose of the urologist was in average 0.07lSv per 1lGym2. The more experienced urologists yielded a mean DAP of 166lGym2 for stage I and 415lGym2 for stage II procedures. The interventionist was exposed with 10lSv in mean outside the lead apron collar. The mean dose value of the eye lenses per intervention was ascertained to 20lSv (mean DAP: 233lGym2).

Guiu-Souto J, Otero-Martinez C, Perez-Fentes D, et al. Characterising Endourologist Learning Curve during Percutaneous Nephrolithotomy: Implications on Occupational Dose and Patients. J Radiol Prot. 2017 Nov 15;37(4):N49-N54.

In this study we have characterised the learning curve for percutaneous nephrolithotomy procedures over 301 cases for six years. Different surrogate parameters of clinical expertise have been used, such as dose area product, total procedure time, fluoroscopy time and personal equivalent doses. In addition, two different endourologists have been monitored; one of whom had specific Radiation Protection training (ICRP 85). Eye lens dose was estimated from thermoluminescent dosimeters. Significant differences were observed between both endourologists, especially in the fluoroscopy time.