Percutaneous nephrolithotomy. With emphasis on large renal stones

Area of Science:

• Nephrology
• Urology
• Surgical Technology

Background:

• Percutaneous nephrolithotomy (PCNL) is a standard procedure for kidney stone removal.
• Managing large or complex stones, such as staghorn calculi, can be challenging.
• Minimally invasive techniques aim to improve stone clearance and patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of percutaneous renal stone removal using specific instruments.
• To assess the utility of Mazzariello-Caprini forceps and Kocher forceps in PCNL.
• To analyze postoperative renal function following the procedure.

Main Methods:

• Percutaneous removal of renal stones was performed in 18 cases.
• Procedures utilized a safety guide wire, dilator (up to 36F), and Mazzariello-Caprini forceps.
• Stone extraction attempts were initiated on the same day as nephrostomy placement.
• Kocher forceps were employed for fragmentation and removal of staghorn calculi.

Main Results:

• Successful percutaneous renal stone removal was achieved in 18 cases.
• Staghorn calculi were present in 5 cases, with complete removal in 1 case and partial removal in 4 cases.
• Renal stones, excluding staghorn calculi, were entirely removed without complications.
• Satisfactory postoperative renal function was observed in all patients.

Conclusions:

• Percutaneous renal stone removal is effective for various renal calculi, including staghorn types.
• Mazzariello-Caprini forceps are suitable for standard PCNL, while Kocher forceps offer a safe and efficient option for staghorn calculus fragmentation.
• The described technique facilitates successful stone clearance and preserves postoperative renal function.