A New Twist on an Old Technique: Lawson Retrograde Endoscopic-Guided Nephrostomy Access for Percutaneous
Kamaljot S Kaler1,2, Egor Parkhomenko1, Cyrus Y Lin1
1Department of Urology, University of California, Irvine, California.
Abstract:
A minority of urologists performing percutaneous nephrolithotomy (PCNL) achieve their own nephrostomy access. In an effort to simplify the access part of PCNL, we herein describe our initial experience with endoscopic-guided retrograde percutaneous access in the prone split-leg position. After informed consent, a confirmed negative urine culture, and 1 week pretreatment with tamsulosin, four carefully selected PCNL patients underwent endoscopic-guided retrograde access in a prone split-leg position using the Lawson catheter. In all the four patients, we achieved endoscopic-guided retrograde upper pole access in the prone split-leg position. A single Clavien 3B complication occurred. Total fluoroscopy time for the PCNL averaged 162 seconds (51-283). Complete stone-free rate at 1 week based on CT scan was 25%, and a stone-free rate defined as <4 mm was 100%. Endoscopic-guided retrograde percutaneous upper pole access can be established efficiently with a modified Lawson technique in the prone split-leg position.
Related Concept Videos
Muscles that Move the Leg
Anterior Compartment
The quadriceps femoris, the most visible muscle of the anterior compartment, is integral for leg extension and thigh flexion. It is formed by merging four distinct muscles — the vastus lateralis, vastus medialis, vastus intermedius, and rectus femoris. The quadriceps tendon, a shared tendon of the four quadriceps muscles, is affixed...
Angle of Twist: Problem Solving
Angle of Twist - Elastic Range
¹H NMR: Complex Splitting
Splitting diagrams or splitting tree diagrams are routinely used to depict such complex couplings. While drawing splitting diagrams, the splitting with the larger coupling constant is usually applied...
Position-effect Variegation
Assessing Blood pressure in the Leg
Preparation:


