Microperc for pediatric nephrolithiasis: technique in valdivia-modified position.

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Nephrolithotomy

Background:

• Micropercutaneous nephrolithotomy (microperc) is a novel technique for adult kidney stone treatment.
• Initial pediatric experience with microperc is limited, necessitating further investigation.

Purpose of the Study:

• To evaluate the safety and efficacy of a modified microperc technique in pediatric patients.
• To assess the feasibility of microperc for treating renal stones in children.

Main Methods:

• A modified technique involved direct calyceal access using a metallic needle under ultrasound and fluoroscopic guidance.
• Holmium:YAG laser lithotripsy was employed for stone fragmentation via a flexible optic wire.
• Patients were positioned in a modified supine Valdivia position.

Main Results:

• Five pediatric patients (18 months to 11 years) underwent microperc for a mean stone size of 15.0 mm.
• The mean operative time was 56 minutes with insignificant blood loss and minimal postoperative discomfort.
• A 100% stone-free rate was achieved at one month, with no ancillary procedures required.

Conclusions:

• Modified microperc is a safe, effective, and minimally invasive option for pediatric kidney stones.
• This technique is cost-effective and time-saving, with potential for treating lower pole and pelvic stones.
• Further multicenter randomized studies are needed to define indications and compare microperc with existing procedures.