A novel 5-part Percutaneous Access Needle with Glidewire technique (5-PANG) for percutaneous nephrolithotomy: our...

To describe the use of an innovative 5-part Percutaneous Access Needle with Glidewire (5-PANG), a novel technique in an attempt to make percutaneous nephrolithotomy (PCNL-a routinely performed procedure) tract establishment a fast, safe, and less cumbersome procedure.

An access needle (5-PANG needle) was designed and fabricated at the Institute of Urology, Dhule, and used for percutaneous renal access during PCNL.

The 5-PANG technique was used in 55 cases (57 renal units). It was used for all calyceal punctures, all types of stones, renal anatomies, and for second-time surgeries (8 cases). The mean time required (from the stage of the successful puncture using the first 3 parts of the needle till the placement of Alken's rod) was 44.54 seconds. The radiation time was a mean of 3.34 seconds. Punctured calyx and tract size did not affect the results. Visual clarity was good in 85.9% cases. No case had to be converted to conventional method or abandoned. There were no intra- or postoperative complications related to the 5-PANG.

We find the 5-PANG technique safe, fast, effective, and inexpensive. It is easy to learn and master. We recommend this technique over the standard initial tract dilatation techniques.