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Published on: March 27, 2018
[Percutaneous renal surgery with minimal access: miniperc]
German de la Torre1, Walter De Bonis, Horacio Rey
1División Urología, Departamento de Cirugía, Hospital Gral, de agudos C.G.Durand, Buenos Aires, Argentina. megafi@infovia.com.ar
Objectives:
To describe the technique of the minimal access percutaneous nephrolithectomy, miniperc, and to analyze the results obtained with this treatment in adult patients.
Methods:
We performed 42 minipercs between august 2002 and December 2003. Mean patient age was 48 years (19-62). The procedure was undertaken using a 14Fr Amplatz sheath. Stone size varied from 1.5-3.5 cm in longest diameter (1.5-7 cm2). Lithofragmentation was performed by pneumatic lithotripsy.
Results:
Average procedure time was 75.2 min. (range from 60 to 120). All patients were discharged within 24 hours. Only three patients (7.1%) have a hematocrit descent over 2 points. No nephrostomy tube was left for the postoperative time. 95.2% of the patients were stone free 1 month after surgery.
Conclusions:
Our results make us consider the minimal access percutaneous nephrolithectomy (Miniperc) a minimal option for the elimination of renal stones, with low morbidity, diminishment of the hospital stays, very low analgesic demand, and no transfusion requirements.
Insights
Minimal access percutaneous nephrolithotomy (miniperc) offers a minimally invasive option for kidney stone removal. This technique demonstrates low morbidity, reduced hospital stays, and high success rates for patients.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Nephrolithiasis Treatment
Context:
- Percutaneous nephrolithotomy (PCNL) is a standard treatment for large renal calculi.
- Traditional PCNL involves larger access tracts, potentially leading to increased morbidity.
- There is a need for less invasive techniques for kidney stone management.
Purpose:
- To describe the technique of minimal access percutaneous nephrolithotomy (miniperc).
- To analyze the outcomes of miniperc in adult patients with renal stones.
- To evaluate the safety and efficacy of the miniperc procedure.
Summary:
- Forty-two miniperc procedures were performed using a 14Fr Amplatz sheath and pneumatic lithotripsy for stones ranging from 1.5-3.5 cm.
- Average operative time was 75.2 minutes, with all patients discharged within 24 hours.
- A stone-free rate of 95.2% was achieved at one month, with minimal hematocrit drop and no postoperative nephrostomy tubes.
Impact:
- Miniperc represents a viable, minimally invasive approach for renal stone elimination.
- The procedure is associated with low morbidity, shorter hospital stays, and minimal analgesic requirements.
- No blood transfusions were necessary, highlighting the safety profile of miniperc.
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