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Percutaneous nephrostomy in supine position.

Luigi Cormio1, Pasquale Annese, Tommaso Corvasce

  • 1Department of Urology and Renal Transplantation, University of Foggia, Foggia, Italy. luigicormio@libero.it

Urology
|February 27, 2007
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Summary

A new supine anterolateral technique for percutaneous nephrostomy (PCN) offers a safer alternative to the traditional prone position. This method improves patient comfort and reduces risks, especially for obese individuals.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Radiology

Background:

  • Traditional percutaneous nephrostomy (PCN) is performed prone to minimize injury to adjacent organs like the colon.
  • The prone position presents challenges including patient discomfort and cardiorespiratory issues, particularly in obese patients.
  • Alternative patient positioning is needed to overcome the limitations of the prone approach in PCN.

Purpose of the Study:

  • To describe and evaluate a novel technique for percutaneous nephrostomy (PCN) in the supine anterolateral position.
  • To assess the safety and efficacy of this supine PCN method.
  • To determine if this technique mitigates the disadvantages associated with the prone position.

Main Methods:

  • Patients were positioned in a 30-degree supine anterolateral position using towel rolls for flank elevation.
  • Ultrasound guidance was employed for puncture of the collecting system.
  • Fluoroscopy was used for precise placement of the nephrostomy tube.

Main Results:

  • The supine anterolateral position effectively moves the colon anteromedially, away from potential puncture tracts.
  • This technique was successfully applied in 12 consecutive patients.
  • The procedure was observed to be easy to perform and safe.

Conclusions:

  • The supine anterolateral percutaneous nephrostomy (PCN) technique is a safe and effective alternative to the prone position.
  • This method significantly reduces patient discomfort and cardiorespiratory compromise.
  • It is particularly beneficial for patients who are obese or have respiratory compromise.