Ocular Radiation Exposure in Endourology
BAUS ePoster online library. Peacock J. 06/21/21; 319099; p6-10
Disclosure(s): None to declare
Mr. Julian Peacock
REGULAR CONTENT
Login now to access Regular content available to all registered users.
Abstract
Discussion Forum (0)
Rate & Comment (0)
Introduction
There is widespread recognition of the risk of laser and splash injury to the eye during endourological procedures. Despite the lens being one the most radiosensitive tissues, the risk of radiation induced cataract is not widely recognised. The aim of this study was to evaluate ocular radiation exposure to the Endourologist, during routine endourological surgery.
Patients and Methods
A prospective study was performed over an 8-month period at a single large District General Hospital. Three procedures were included – ureteric stent insertion, ureteroscopy, and percutaneous nephrolithotomy. Each surgeon was issued a dosimeter, worn on the glabella. Fluoroscopy Time (FT) and Dose Area Product (DAP) were recorded for each case.
Results
A total of 404 procedures were included (247 ureteroscopies (URS), 150 ureteric stent insertions and 7 percutaneous nephrolithotomy (PCNL)). Dosimeters were worn by 10 surgeons. Mean fluoroscopy times (URS 20.56 s; ureteric stent 18.96 s; PCNL 360.67 s) and mean DAP (URS 100.82 cGy.m2, ureteric stent 119.82 cGy.m2 and PCNL 1121.62 cGy.m2) were identified with large inter-surgeon variability. No surgeon had a total dosimeter dose >0.00mSv.
Conclusions
The International Commission on Radiological Protection (ICRP) recently reduced the yearly eye dose limit from 150 to 20 mSv. Cataractogenesis is no longer considered a typical deterministic effect, with a threshold level below which no effect occurs. Even in higher volume centres, these annual limits are unlikely to be reached. Lead glasses may be considered for surgeons and radiologists with the highest exposure, but for the majority, ocular radiation exposure is negligible.
There is widespread recognition of the risk of laser and splash injury to the eye during endourological procedures. Despite the lens being one the most radiosensitive tissues, the risk of radiation induced cataract is not widely recognised. The aim of this study was to evaluate ocular radiation exposure to the Endourologist, during routine endourological surgery.
Patients and Methods
A prospective study was performed over an 8-month period at a single large District General Hospital. Three procedures were included – ureteric stent insertion, ureteroscopy, and percutaneous nephrolithotomy. Each surgeon was issued a dosimeter, worn on the glabella. Fluoroscopy Time (FT) and Dose Area Product (DAP) were recorded for each case.
Results
A total of 404 procedures were included (247 ureteroscopies (URS), 150 ureteric stent insertions and 7 percutaneous nephrolithotomy (PCNL)). Dosimeters were worn by 10 surgeons. Mean fluoroscopy times (URS 20.56 s; ureteric stent 18.96 s; PCNL 360.67 s) and mean DAP (URS 100.82 cGy.m2, ureteric stent 119.82 cGy.m2 and PCNL 1121.62 cGy.m2) were identified with large inter-surgeon variability. No surgeon had a total dosimeter dose >0.00mSv.
Conclusions
The International Commission on Radiological Protection (ICRP) recently reduced the yearly eye dose limit from 150 to 20 mSv. Cataractogenesis is no longer considered a typical deterministic effect, with a threshold level below which no effect occurs. Even in higher volume centres, these annual limits are unlikely to be reached. Lead glasses may be considered for surgeons and radiologists with the highest exposure, but for the majority, ocular radiation exposure is negligible.
Introduction
There is widespread recognition of the risk of laser and splash injury to the eye during endourological procedures. Despite the lens being one the most radiosensitive tissues, the risk of radiation induced cataract is not widely recognised. The aim of this study was to evaluate ocular radiation exposure to the Endourologist, during routine endourological surgery.
Patients and Methods
A prospective study was performed over an 8-month period at a single large District General Hospital. Three procedures were included – ureteric stent insertion, ureteroscopy, and percutaneous nephrolithotomy. Each surgeon was issued a dosimeter, worn on the glabella. Fluoroscopy Time (FT) and Dose Area Product (DAP) were recorded for each case.
Results
A total of 404 procedures were included (247 ureteroscopies (URS), 150 ureteric stent insertions and 7 percutaneous nephrolithotomy (PCNL)). Dosimeters were worn by 10 surgeons. Mean fluoroscopy times (URS 20.56 s; ureteric stent 18.96 s; PCNL 360.67 s) and mean DAP (URS 100.82 cGy.m2, ureteric stent 119.82 cGy.m2 and PCNL 1121.62 cGy.m2) were identified with large inter-surgeon variability. No surgeon had a total dosimeter dose >0.00mSv.
Conclusions
The International Commission on Radiological Protection (ICRP) recently reduced the yearly eye dose limit from 150 to 20 mSv. Cataractogenesis is no longer considered a typical deterministic effect, with a threshold level below which no effect occurs. Even in higher volume centres, these annual limits are unlikely to be reached. Lead glasses may be considered for surgeons and radiologists with the highest exposure, but for the majority, ocular radiation exposure is negligible.
There is widespread recognition of the risk of laser and splash injury to the eye during endourological procedures. Despite the lens being one the most radiosensitive tissues, the risk of radiation induced cataract is not widely recognised. The aim of this study was to evaluate ocular radiation exposure to the Endourologist, during routine endourological surgery.
Patients and Methods
A prospective study was performed over an 8-month period at a single large District General Hospital. Three procedures were included – ureteric stent insertion, ureteroscopy, and percutaneous nephrolithotomy. Each surgeon was issued a dosimeter, worn on the glabella. Fluoroscopy Time (FT) and Dose Area Product (DAP) were recorded for each case.
Results
A total of 404 procedures were included (247 ureteroscopies (URS), 150 ureteric stent insertions and 7 percutaneous nephrolithotomy (PCNL)). Dosimeters were worn by 10 surgeons. Mean fluoroscopy times (URS 20.56 s; ureteric stent 18.96 s; PCNL 360.67 s) and mean DAP (URS 100.82 cGy.m2, ureteric stent 119.82 cGy.m2 and PCNL 1121.62 cGy.m2) were identified with large inter-surgeon variability. No surgeon had a total dosimeter dose >0.00mSv.
Conclusions
The International Commission on Radiological Protection (ICRP) recently reduced the yearly eye dose limit from 150 to 20 mSv. Cataractogenesis is no longer considered a typical deterministic effect, with a threshold level below which no effect occurs. Even in higher volume centres, these annual limits are unlikely to be reached. Lead glasses may be considered for surgeons and radiologists with the highest exposure, but for the majority, ocular radiation exposure is negligible.
Code of conduct/disclaimer available in General Terms & Conditions
{{ help_message }}
{{filter}}