Percutaneous Micronephrolithotomy: Description of a Variation of the Original Technique

  • João Ferreira Cabral Serviço de Urologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto
  • D. Carneiro Serviço de Urologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto
  • I. Campos Braga Serviço de Urologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto
  • M. Silva Campos Serviço de Urologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto
  • Vitor Cavadas Serviço de Urologia, Hospital de Santo António, Centro Hospitalar do Porto, Porto
Keywords: Kidney Calculi/surgery, Nephrostomy, Percutaneous

Abstract

The micropercutaneous nephrolithotomy (microperc) is the ultimate technological advance in the treatment of urolithiasis. We describe a variation of the original technique and it´s additional advantages to this surgical approach. A woman of 67 years old with a body mass index of 28.6 kg/ m2 with a stone of 25 x 20 mm in the left renal pelvis was positioned in Valdivia - Galdakao decubitus. After retrograde pielography, it was placed a ureteral access sheath 11/13 F to the level of the ureteropelvic junction. The puncture of the kidney was performed under fluoroscopic guidance. The stone was disintegrated with holmium laser. At the end of the procedure it was performed a flexible nephroscopy to comprove the stone free status.

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References

1. Dwyer ME, Krambeck AE, Bergstralh EJ, Milliner DS, Lieske JC, Rule AD. Temporal trends in incidence of kidney stones among children: a 25-year population based study. J Urol. 2012; 188: 247–52.
2. Marickar YM, Vijay A. Female stone disease: the changing trend. Urol Res. 2009; 37: 337–40.
3. Türk C, Knoll T, Petrik A. European Association of Urology Guidelines on Urolithiasis. Uroweb 2012. [accessed Jan 2017] Available from: http://www.uroweb.org/gls/pdf/20_
4. Srisubat A, Potisat S, Lojanapiwat B, Setthawong V, Laopaiboon M. Extracorporeal shock wave lithotripsy (ESWL) versus percutaneous nephrolithotomy (PCNL) or retrograde intrarenal surgery (RIRS) for kidney stones.
Cochrane Database Syst Rev. 2014;11:CD007044.
5. Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol. 2005; 51: 899–906.
6. Kukreja R, Desai M, Patel S, Bapat S, Desai M. Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. 2004; 18: 715–22.
7. Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M. Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol. 2011; 186: 140–5.
8. Bader MJ, Gratzke C, Seitz M, Sharma R, Stief CG, Desai M. The ‘all-seeing needle’: initial results of an optical puncture system confirming access in percutaneous nephrolithotomy. Eur Urol. 2011; 59: 1054–9.
9. Sabnis RB, Ganesamoni R, Doshi A, Ganpule AP, Jagtap J, Desai MR. Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled
trial; BJU Int. 2013; 112:355-61.
10. Tepeler A, Armagan A, Sancaktutar AA, Silay MS, Penbegul N, Akman T, et al. The role of microperc in the treatment of symptomatic lower pole renal calculi. J Endourol. 2013; 27:13–8.
11. Bagcioglu M, Demir A, Sulhan H, Karadag MA, Uslu M, Tekdogan UY. Comparison of flexible ureteroscopy and micropercutaneous nephrolithotomy in terms of cost-effectiveness: analysis of 111 procedures. Urolithiasis.
2016; 44:339-44. d
12. Armagan A, Tepeler A, Silay MS, Ersoz C, Akcay M, Akman T, et al. Micropercutaneous nephrolithotomy in the treatment of moderate-size renal calculi. J Endourol. 2013; 27:177–81.
13. Armagan A, Karatag T, Buldu I. Comparison of flexible ureterorenoscopy and micropercutaneous nephrolithotomy in the treatment for moderately size lower-pole stones. World J Urol. 2015; 33:1827–31.
14. Tepeler A, Akman T, Silay MS, Akcay M, Ersoz C, Kalkan S, et al. Comparison of intrarenal pelvic pressure during micropercutaneous nephrolithotomy and conventional percutaneous nephrolithotomy. Urolithiasis. 2014;
42:275-9.
15. Akbulut F, Ucpinar B, Savun M, Kucuktopcu O, Ozgor F, Simsek A, et al. A major complication in micropercutaneous nephrolithotomy: upper calyceal perforation with extrarenal migration of stone fragments due to increased intrarenal pelvic pressure. Case Rep Urol. 2015:792780.
16. Guohua Z, Wen Z, Xun l, Wenzhong C, Yongzhong H, Zhaohui H, et al. The influence of minimally invasive percutaneous nephrolithotomy on renal pelvic pressure in vivo. Surg Laparosc Endosc Percutan Tech. 2007:
17:307– 10.
17. Troxel SA, Low RK. Renal intrapelvic pressure during percutaneous nephrolithotomy and its correlation with the development of postoperative fever. J Urol. 2002: 168:1348–51.
18. Penbegul N, Bodakci MN, Hatipoglu NK, Sancaktutar AA, Atar M, Cakmakci S, et al. Microsheath for microperc: 14-gauge angiocath. J Endourol. 2013; 27:835-9.
Published
2017-12-17