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Objective To evaluate the peri-operative outcomes of retrograde intrarenal surgery (RIRS) using flexible and navigable suction (FANS) ureteral access sheath (UAS) in children less than 2 years age. The primary objective was to assess the single-stage stone free rate. The secondary objectives included the evaluation of operative time, intraoperative visibility, need for reintervention, complication rates and length of hospitalization.Materials and Methods A prospective single centre observational study was done in children less than 2 years age, who underwent RIRS using FANS UAS, from from October 2023 to November 2024. Demographic data, operative parameters were recorded. Intraoperative visibility was assessed using Likert’s scale (grade 1- excellent, grade 2 – average, grade 3 – poor). Complications were graded according to the Clavien-Dindo (CD) classification system.Results Twenty-one children were included and analysed. The median age was 12.00 (10.00–14.25) months and the median stone size was 11.00 (9.00–13.12) mm. The median operative time was 32.00 (25.75–37.25) min. Grade 1 intraoperative visibility was noted in 100% of patients and 3 out of 21 had grade 1 lower ureteric injury due to access sheath placement. 2 out of 21 (9.5%) patients had CD Grade 1 fever, 4 out of 21 (19%) patients had CD grade 1 hematuria. 95.2% were stone free in a single stage, at 4 weeks and none required re-intervention. The median follow-up period was 11.00 (8.75–12.00) months.Conclusion FANS UAS for RIRS in children ( < 24 months) improves single-stage SFR, reduces infections, and lowers re-interventions without serious complications. Its use, ideally by experienced urologists in tertiary centres, confirms its potential as a game-changer
Vaddi et al. (Thu,) studied this question.