Percutaneous Kidney Stone Removal

Alken, P.; Hutschenreiter, G.; Günther, Rolf W.

doi:10.1159/000473540

Cited by 77 publications

(19 citation statements)

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“…[1][2][3][4][5][6][7] Most of the bleeding that is related to PCNL can be managed with supportive treatment, and only 0.8% of patients need angioembolization to control intractable bleeding. 8 Without a shadow of a doubt, establishing optimal access to the renal collecting system is a key point for diminishing bleeding and improving success.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Bleeding During Percutaneous Nephrolithotomy: Single Surgeon Experience

Akman

Binbay²,

Sarı³

et al. 2011

Journal of Endourology

154

109

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Section: Introductionmentioning

confidence: 99%

Factors Affecting Bleeding During Percutaneous Nephrolithotomy: Single Surgeon Experience

Akman

Binbay²,

Sarı³

et al. 2011

Journal of Endourology

154

109

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“…Technological improvements have provided urologists with a wide armamentarium of dilation devices for kidney access, with sizes ranging from 4.8 to 30 French (Fr) [2, 3, 4]. Miniaturization of instruments has impacted on indications, as smaller tracts theoretically reduce complications such as blood loss [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Renal parenchyma injury after percutaneous nephrolithotomy tract dilatations in pig and cadaveric kidney models

Emiliani

Talso

Baghdadi

et al. 2017

CEJU

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IntroductionMiniaturization of instruments has changed the paradigms of percutaneous nephrolithotomy (PCNL). To date, however, few studies have analyzed the possible renal trauma generated by PCNL tract dilation. The purpose of this study is to evaluate and compare systematically the renal injury of all PNCL dilation techniques in pork kidneys (PK) and cadaveric kidney models (CK).Material and methodsTwelve dilation devices were tested (from 4.8 to 30 French (Fr)) including micro- and mini- PCNL kits, the Alken dilation set, 20 and 30 ATM balloons and the Amplatz set. Each device was tested six times in PK and CK. Morphologic analysis of tract defects of the different models and dilators were made measuring the longest axis and the area of renal parenchymal damage.ResultsWhen comparing the PK and CK dilation tract areas to the device areas, major differences were seen with the 20 ATM 30 Fr balloon (p = 0.0001 and 0.008) respectively, the sequential Amplatz dilation to 30 Fr (p = 0.0005 and 0.0006) respectively, and the Alken 30 FR dilation (p = 0.012 and 0.02) respectively. The 30 Fr dilations were 32.76 mm2 (mean) larger than the instruments themselves, while the ≤24 Fr dilations were 11.6 mm2 (mean) larger than the instruments themselves.ConclusionsWhen comparing devices and tract areas, the dilation tract area exceeded device area by 11.6 mm2 at dilations up to 24 Fr vs. 32.76 mm2 with dilations of 30 Fr. Overall, PK had significantly larger injuries than CK models.

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“…Back in 1955 it was described as the use of a needle to decompress a kidney with hydronephrosis [1,2]; but it was not until 1976, when Fernstrom and Johansson [3] succeeded in removing nephrolithiasis through a percutaneous tract for the first time, that percutaneous surgery began to develop. With the description of the technique according to the experience of Alken [4] and later Segura [5], there was a breakthrough in the universalization of standardized technical steps in prone percutaneous nephrolithotomy. There are various methods to perform a kidney puncture, such as fluoroscopy, ultrasound or both.…”

Section: Introductionmentioning

confidence: 99%

Performing easy prone punction

2017

CEJU

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Introduction Percutaneous renal surgery has been considered one of the most important advances in urology. There are several possibilities to perform a kidney puncture such as using fluoroscopy, ultrasound or both. The aim of this article is to describe our puncture technique. Material and methods Correct puncture is one of the most critical and challenging steps during percutaneous surgery. Bull's eye technique and other similar techniques supported by fluoroscopy try to make triangulations and provide different views. On the other hand, many urologists prefer the usage of ultrasound to help reach the calyx. The perfect puncture could also be a scanner guided puncture. Results Under general anesthesia, cystoscopy is performed for ureteral catheter placement. The excretory system is opacified by administering contrast to the ureteral catheter. Perpendicular puncture on the selected calyx is done; this is a 90° puncture with a fine spinal needle 20G into the selected calyx under fluoroscopy control to visualize the correct penetration into the calyx. Moving forward to the next step, an 18G needle is used to follow the correct calyx -infundibulum -renal pelvis path. The goal is to put together both tips of the 2 needles (needle Kiss technique). Conclusions After several years of performing percutaneous surgery, we conclude that our technique can facilitate the prone position puncture thanks to the information given from the thin needle while simultaneously minimizing the use of fluoroscopy for triangulation maneuvers and avoiding the use of ultrasound to determine the depth of the target calyx.

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Percutaneous Kidney Stone Removal

Cited by 77 publications

References 0 publications

Factors Affecting Bleeding During Percutaneous Nephrolithotomy: Single Surgeon Experience

Factors Affecting Bleeding During Percutaneous Nephrolithotomy: Single Surgeon Experience

Renal parenchyma injury after percutaneous nephrolithotomy tract dilatations in pig and cadaveric kidney models

Performing easy prone punction

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