[Nephrolithotomy using Doppler and dynamic sonography]

In open operations of coralliform or multiple small nephrolithiasis frequently the problem of peroperative localization of residual concrements arises. A simple, reliable, accurate and non-aggressive peroperative detection of concrements in the kidney is made possible by ultrasonography. The method was used in 25 cases, a probe with a frequency of 7.5 MHz makes it possible to detect even minute fragments. On the screen we can see not only the size of concrements but also their distance from the surface, and their position can be accurately assessed three-dimensionally. The surgeon thus can make nephrotomy aimed directly on the concrement. The course of major blood vessels can be detected by means of a Dopplers probe. This procedure makes it possible to make the incision in a relatively avascular zone without the necessity of the application of cooling or ischaemia of the kidney. In the investigated group no false positive finding was obtained, a false negative finding can result from non-systematic examination.