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

Publish Year: 1400
نوع سند: مقاله ژورنالی
زبان: English
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JR_TUMS-3-1_002

تاریخ نمایه سازی: 17 فروردین 1400

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. The aim of this study is 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 which 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.

Authors

Hamidreza Zia

Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Fatemeh Khatami

Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Mohammad Rahimi

Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

Seyed Mohammad Kazem Aghamir

Urology Research Center, Tehran University of Medical Sciences, Tehran, Iran

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