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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
[Multimodal approach to the treatment of staghorn stones in modern clinic]
S V Popov1,2, I N Orlov1,2, F R Asfandiyarov1,2
1Department of Urology of FGBOU VO North-Western State Medical University named after I.I. Mechnikov, GBUZ Public Hospital of Saint Luca, Saint Petersburg, Russia.
Abstract:
This lecture is dedicated to increasing stone free rate (SFR) in patients with staghorn renal stones by using a multimodal approach. Percutaneous nephrolithotomy (PCNL) is the "gold standard" for the treatment of this group of patients. Depending on a stone size and complexity, SFR for PCNL varies from 55 to 98%. Due to low SFR, which is a main criterion for the effective procedure, various approaches currently are being suggested. In this lecture, we highlighted the following approaches: multi-access PCNL, a use of a ureteroscope in case of antegrade stone migration, a use of flexible instruments, ureterorenoscopy in combination with PCNL. Various lithotripsy techniques are briefly described. The advantage of ultrasound-guided puncture of the kidney is also discussed.
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