Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
Journal Title: Translational Research in Urology - Year 2021, Vol 3, Issue 1
Abstract
Introduction Percutaneous nephrolithotomy (PCNL) is a common urological procedure. Obtaining secure percutaneous access to the collecting system which is usually done under fluoroscopic guidance and tract dilatation is a crucial step toward a successful and safe procedure. This study aims to introduce a novel technique to modify this procedure. Method Combined Direct Visual and Imaging Guided PCNL is performed by using specific 28 Fr dilatators with a customized central lumen that accepts a 4.5 F semi-rigid ureteroscope to visually confirm the puncture of the target calyx and passing a guidewire. This instrument was passed as a one-shot dilator after the withdrawal of the puncture needle. The rest of the procedure was then carried out in a standard manner. This novel technique was introduced to 12 patients in 2020 in Sina hospital, after completing the informed consent. Results The mean age was 53.58±11.96 and the average stone size was 4.1±0.58 cm and the average time from insertion of the needle into the target calyx until securing a guide wire inside the collecting system (pelvis, ureter) was 95 seconds (84-107). Fluoroscopy time (total time required to obtain the access but not the whole operation) was on average 30.25±8.01 seconds. There were no intraoperative or postoperative complications as a result of this technique. Conclusions The use of the ureteroscope loaded with the dilator and sheath during PNCL seems to be a feasible and safe technique for dilatation of the access tract during one shot PCNL.
Authors and Affiliations
Hamidreza Zia Fatemeh Khatami Mohammad Reza Rahimi Seyed Mohammad Kazem Aghamir
Keywords
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- EP ID EP704071
- DOI 10.22034/TRU.2020.257597.1051
- Views 93
- Downloads 0
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