Percutaneous Stone Manipulation

Abstract

Percutaneous stone manipulation by direct ultrasound disintegration, extraction or chemolysis was done on 34 patients. A total of 15 patients presented with an operatively established nephrostomy, while percutaneous nephrostomy and subsequent dilation of the nephrostomy channel were done in 19. The rate of complete stone clearance was 19 of 20 stones after percutaneous nephrostomy and 8 of 16 stones in the group with an operatively established nephrostomy. The primary goal, to remove obstructing pelvic stones, was achieved in all cases. There were no untoward side effects, such as back pressure damage owing to flushing of the collecting system during ultrasound disintegration, or persistent infection. Complications in 3 patients were managed conservatively.

Mechanical testing of urinary calculi

“…One hundred years later the first patient with a kidney stone was successfully treated with extracorporeal shockwave lithotripsy (ESWL) in Munich [3]. At a similar time, percutaneous nephrolithotomy (PCNL) was being developed in Germany and England, although the first PCNL had been performed earlier by FernstrOm in 1976 [1,24,25]. Subsequently, open surgery for stone disease has become almost totally replaced by techniques based upon stone fragmentation and/or extraction.…”

Moderne Steintherapie

“…1971 stellten Takagi et al [28] ein erstes flexibles 6-Ch-Ureterorenoskop vor. Parallel hierzu beschrieben Fernstrom u. Johansson 1976 [29] den perkutanen endoskopischen Zugang zur Extraktion von Nierensteinen [30].…”

Renal Stone Disease: The Urological Perspective

“…As with all endoscopic procedures in urology, a prior urine culture must be checked and broad-spectrum antibiotic cover given, even if the urine is sterile. Described by Alken et al [12], the principle of PCNL is simple and consists of creating a tunnel from the overlying skin to the kidney calyx containing the stone, so that a nephroscope can be passed to visualise the stone and its direct removal or in situ fragmentation with a Lithoclast or laser. The puncture site and tract can be performed using US or fluoroscopy.…”