A Preliminary Report on the Safety and Efficacy of a Novel CT-Guided Puncture Device for Adult Percutaneous Nephrolithotomy

Objective: A new type of CT-guided puncture device (CT-GPD) has been developed. We aimed to evaluate and compare the puncture accuracy and stone-free rates (SFRs) for percutaneous nephrolithotomy (PCNL) between the CT-GPD puncture group, the X-ray-guided group, and the free-hand CT-guided (FH-CTG) group. Methods: From September 2023 to September 2024, 51 patients were divided into CT-GPD, FH-CTG, and X-ray-guided groups to perform PCNL. Basic patient data, procedure details, radiation exposure, puncture time, complications, and SFRs were recorded and analyzed. Results: There was no significant difference in the patients’ demographics, including age, sex, body mass index, and stone characteristics, among the three groups. The indices of puncture time, puncture success rate, and the number of punctures in the CT-GPD group were 10.88 ± 2.07 minutes, 100%, and 1.82 ± 0.73, respectively, which were significantly better ( p < 0.05) than the other two groups. Compared with the FH-CTG group, the effective dose and the number of CT scans in the CT-GPD group were reduced by 11.2% ( p = 0.006) and 23.6% ( p = 0.006), respectively. Conclusion: CT-GPD is a valuable tool for establishing PCNL access. It may increase puncture accuracy, reduce radiation exposure, and avoid injury to the renal vascular and surrounding soft tissue without sacrificing the SFRs. This device may be especially beneficial for novices in PCNL.