TZ-RIRS vs. C-RIRS for Kidney Stones

This study evaluates a new minimally invasive surgical technique for treating kidney stones called Triple-Zero Retrograde Intrarenal Surgery (TZ-RIRS). Traditionally, RIRS is performed using three standard tools: X-ray guidance (fluoroscopy), a plastic tube to keep the ureter open (ureteral access sheath or UAS), and a stent placed before surgery to widen the ureter. While effective, these tools expose patients to radiation, can cause ureteral injuries, and require an extra procedure for the preoperative stent. The \"Triple-Zero\" approach aims to eliminate all three: zero fluoroscopy, zero UAS, and zero preoperative stents. Because this technique is technically demanding, the researchers also developed a new tool called the \"TZ-STONE score.\" This score uses five pre-operative factors (stone size, location, blockage, number of stones, and stone density) to predict which patients are the best candidates for this simplified surgery. The study compares the safety and success rates of patients who underwent the Triple-Zero approach with those who had conventional RIRS. The researchers aim to see if the Triple-Zero approach achieves similar stone-free rates while reducing radiation exposure, minimizing ureteral injuries, and avoiding the need for a preoperative stent.