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A novel drainage technique during micropercutaneous nephrolithotomy in pediatric patients: double angiocath
Necmettin Penbegul1, Mehmet Mazhar Utangac1, Mansur Daggulli1
1Dicle University School of Medicine, Department of Urology, 21280 Diyarbakir, Turkey.
Abstract:
Micropercutaneous nephrolithotomy (microperc) is a recently introduced percutaneous nephrolithotomy (PNL) technique that has the smallest tract size. The absence of an amplatz sheath during the microperc technique is a fundamental difference that distinguishes it from all other types of PNL (standard, mini, ultramini). Increasing of the intrarenal pelvic pressure (IPP) was demonstrated by the authors in adult patients but this problem may be even more serious in pediatric patients. Previously, the authors defined the use of a 14 gauge angiocath needle and sheath (microsheath) during microperc surgery for pediatric patient to reduce the IPP. In this novel technique, a second angiocath is used to access the renal collecting system to drain fluid during surgery. This technique is more effective in reducing IPP during microperc, especially in pediatric patients.
Insights
Micropercutaneous nephrolithotomy (microperc) can increase intrarenal pelvic pressure (IPP), especially in children. A novel technique using a second angiocath to drain fluid effectively reduces IPP during pediatric microperc surgery.
Area of Science:
- Urology
- Minimally Invasive Surgery
Background:
- Micropercutaneous nephrolithotomy (microperc) is a PNL technique with the smallest tract size.
- Microperc differs from other PNL types by its absence of an amplatz sheath.
- Increased intrarenal pelvic pressure (IPP) is a known issue in adult microperc, potentially more severe in pediatric cases.
Purpose of the Study:
- To address the challenge of elevated intrarenal pelvic pressure (IPP) during micropercutaneous nephrolithotomy (microperc) in pediatric patients.
- To introduce and evaluate a novel technique for reducing IPP during pediatric microperc.
Main Methods:
- A modified microperc technique was employed for pediatric patients.
- A 14-gauge angiocath needle and sheath (microsheath) were utilized.
- A second angiocath was introduced to access the renal collecting system for fluid drainage during the procedure.
Main Results:
- The novel technique effectively reduces intrarenal pelvic pressure (IPP) during microperc.
- This method is particularly beneficial for pediatric patients undergoing microperc surgery.
Conclusions:
- The described dual-angiocath technique is effective in mitigating increased intrarenal pelvic pressure (IPP) during micropercutaneous nephrolithotomy (microperc).
- This approach offers a valuable solution for enhancing the safety and efficacy of pediatric microperc procedures.
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