Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique

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 introd...

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Autores principales:	Hamidreza Zia, Fatemeh Khatami, Mohammad Reza Rahimi, Seyed Mohammad Kazem Aghamir
Formato:	article
Lenguaje:	EN
Publicado:	Urology Research Center 2021
Materias:	technique percutaneous nephrolithotomy nephrolithiasis iran Diseases of the genitourinary system. Urology RC870-923
Acceso en línea:	https://doaj.org/article/d6e749c7ee014791bae5c40ee34b8c53
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spelling	oai:doaj.org-article:d6e749c7ee014791bae5c40ee34b8c532021-11-27T05:48:10ZCombined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique10.22034/TRU.2020.257597.10512717-042Xhttps://doaj.org/article/d6e749c7ee014791bae5c40ee34b8c532021-02-01T00:00:00Zhttps://www.transresurology.com/article_119768.htmlhttps://doaj.org/toc/2717-042XIntroduction 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 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 in 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 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 averagely 30.25±8.01 seconds. There were no intraoperative or postoperative complications as a result of this technique. Conclusions Use of the ureteroscope loaded with the dilator and sheath during PNCL seems to be a feasible and safe technique for dilatation of access tract during one shot PCNL.Hamidreza ZiaFatemeh KhatamiMohammad Reza RahimiSeyed Mohammad Kazem AghamirUrology Research CenterarticletechniquepercutaneousnephrolithotomynephrolithiasisiranDiseases of the genitourinary system. UrologyRC870-923ENTranslational Research in Urology, Vol 3, Iss 1, Pp 4-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	technique percutaneous nephrolithotomy nephrolithiasis iran Diseases of the genitourinary system. Urology RC870-923
spellingShingle	technique percutaneous nephrolithotomy nephrolithiasis iran Diseases of the genitourinary system. Urology RC870-923 Hamidreza Zia Fatemeh Khatami Mohammad Reza Rahimi Seyed Mohammad Kazem Aghamir Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
description	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 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 in 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 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 averagely 30.25±8.01 seconds. There were no intraoperative or postoperative complications as a result of this technique. Conclusions Use of the ureteroscope loaded with the dilator and sheath during PNCL seems to be a feasible and safe technique for dilatation of access tract during one shot PCNL.
format	article
author	Hamidreza Zia Fatemeh Khatami Mohammad Reza Rahimi Seyed Mohammad Kazem Aghamir
author_facet	Hamidreza Zia Fatemeh Khatami Mohammad Reza Rahimi Seyed Mohammad Kazem Aghamir
author_sort	Hamidreza Zia
title	Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
title_short	Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
title_full	Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
title_fullStr	Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
title_full_unstemmed	Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique
title_sort	combined direct visual and imaging guided percutaneous nephrolithotomy: a novel technique
publisher	Urology Research Center
publishDate	2021
url	https://doaj.org/article/d6e749c7ee014791bae5c40ee34b8c53
work_keys_str_mv	AT hamidrezazia combineddirectvisualandimagingguidedpercutaneousnephrolithotomyanoveltechnique AT fatemehkhatami combineddirectvisualandimagingguidedpercutaneousnephrolithotomyanoveltechnique AT mohammadrezarahimi combineddirectvisualandimagingguidedpercutaneousnephrolithotomyanoveltechnique AT seyedmohammadkazemaghamir combineddirectvisualandimagingguidedpercutaneousnephrolithotomyanoveltechnique
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Combined Direct Visual and Imaging Guided Percutaneous Nephrolithotomy: A Novel Technique

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