Supracostal approach for percutaneous ultrasonic lithotripsy

The supracostal approach to renal access for ultrasonic lithotripsy continues to be used with good results at The Oregon Health Sciences University when indicated, because it provides better access to much of the kidney collecting system and proximal ureter. The complication rate is acceptably low if the precautions outlined above are followed. Access above the 11th rib is discouraged unless there is no other choice.