Percutaneous nephrolithotomy: Three-needle technique on two planes. Cury's technique

Area of Science:

• Urology
• Surgical Innovation
• Nephrolithiasis Management

Background:

• Percutaneous nephrolithotomy (PCNL) is the primary surgical approach for kidney stones exceeding 2 cm.
• The study addresses the need for refined PCNL techniques to minimize patient morbidity.

Purpose of the Study:

• To describe a novel three-needle technique for percutaneous nephrolithotomy performed on two planes.
• To evaluate the efficacy and safety of this innovative surgical approach.

Main Methods:

• The technique involves precise needle placement in the renal pelvis and inferior calyces under nephroscopic guidance.
• A specific incision and sequential needle use facilitate guidewire passage and dilation for stone extraction.
• Patient positioning includes lithotomy for initial cystoscopy and ventral decubitus for the core PCNL procedure.

Main Results:

• The described three-needle technique has been successfully employed for 15 years.
• This method demonstrates reduced morbidity and fewer complications compared to standard PCNL.
• There is a decreased requirement for nephrostomy tube placement post-procedure.

Conclusions:

• The three-needle PCNL technique is associated with significant advantages, including lower morbidity and fewer complications.
• The technique leads to reduced reliance on post-operative nephrostomy tubes.
• It is characterized by ease of learning and high reproducibility, making it suitable for wider adoption.