This randomized clinical trial will compare four ventilation strategies during retrograde intrarenal surgery performed under general anesthesia. The study aims to determine whether reducing respiratory-related kidney movement improves surgical success and decreases perioperative complications. Eighty adult patients will be randomly assigned to standard ventilation, hypoventilation, intermittent apnea ventilation, or one-lung ventilation. Surgical outcomes and perioperative complications will be compared between groups.
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Parallel
Standard Ventilation
Procedure/SurgeryVolume-controlled mechanical ventilation using standard ventilator settings during general anesthesia.
Hypoventilation
Procedure/SurgeryVolume-controlled mechanical ventilation using reduced tidal volume and respiratory rate during general anesthesia.
Intermittent Apnea Ventilation
Procedure/SurgeryIntermittent apnea periods applied during selected stages of retrograde intrarenal surgery to reduce kidney motion.
One-Lung Ventilation
Procedure/SurgeryOne-lung ventilation applied during selected stages of retrograde intrarenal surgery to reduce kidney motion.
Kidney Motion During Retrograde Intrarenal Surgery
Kidney motion during surgery will be evaluated and compared among the four ventilation strategies.
Stone-free Rate
Percentage of patients who are stone-free after retrograde intrarenal surgery.
Operative Time
Total duration of surgery measured from the beginning to the end of the surgical procedure.
Fluoroscopy Time
Total fluoroscopy exposure time recorded during the procedure.
Laser Activation Time
Total duration of laser use during stone fragmentation.
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