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Fluoroscopy-guided renal access in supine percutaneous nephrolithotomy
András Hoznek1, Idir Ouzaid, Matthew Gettman
1Service d'Urologie, Centre Hospitalier Universitaire Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France.
Urology
|May 10, 2011
Summary
This study presents a simple, reproducible fluoroscopy-guided renal access technique for supine percutaneous nephrolithotomy (sPCNL). The method aids urologists, especially those less familiar with ultrasound, in achieving successful stone removal.
Area of Science:
- Urology
- Nephrology
- Medical Imaging
Background:
- Supine percutaneous nephrolithotomy (sPCNL) is a common procedure for kidney stone removal.
- Achieving successful renal access is critical for sPCNL outcomes.
- Ultrasound guidance, while common, can be challenging in certain cases.
Purpose of the Study:
- To detail a standardized, reproducible fluoroscopy-guided renal access method for sPCNL.
- To evaluate the efficacy and safety of this fluoroscopic technique.
Main Methods:
- A cohort of 35 patients undergoing sPCNL was studied.
- In 10 patients with unsuccessful ultrasound-guided access, a fluoroscopy-guided technique was employed.
- This involved C-arm cephalad tilting during targeted calyx puncture.
Main Results:
- The mean fluoroscopic puncture time was 50 seconds.
- Successful access was achieved in all 10 patients, with 7 requiring only one attempt.
- No complications were reported related to the fluoroscopic puncture technique.
Conclusions:
- Fluoroscopy-guided renal access is an easy and reproducible adjunct to ultrasound in sPCNL.
- This technique offers a valuable alternative for urologists less experienced with ultrasound-guided access.
- It enhances the safety and success rate of percutaneous nephrolithotomy.
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