Supine mini PCNL in infants using conventional cystoscope

Area of Science:

• Pediatric Urology
• Minimally Invasive Surgery
• Nephrolithotomy

Background:

• Presents a simplified technique for supine mini percutaneous nephrolithotomy (PCNL) in infants.
• Utilizes conventional compact cystoscopes and commonly available pediatric urology instruments.
• Enhances accessibility, particularly in resource-limited settings.

Purpose of the Study:

• To describe a modified mini PCNL approach for infants.
• To evaluate its feasibility, safety, and efficacy.
• To reduce invasiveness and improve recovery in pediatric patients.

Main Methods:

• Supine positioning with flank elevation and extended lithotomy.
• Retrograde placement of a 3Fr ureteric catheter via cystoscopy.
• Fluoroscopic guidance for lower/mid calyx puncture, sheath insertion, and Holmium:YAG laser lithotripsy.
• Antegrade DJ stent insertion for fragment clearance.

Main Results:

• Five infants (median age 15 months) with pelvic stones (13-19 mm) were treated.
• Mean operative time was 40 minutes.
• No complications were reported, with complete stone clearance at 1-year follow-up.

Conclusions:

• The modified supine mini PCNL is minimally invasive, enhancing recovery in infants.
• Supine positioning improves anesthetic safety and avoids repositioning.
• Further studies are recommended to validate long-term outcomes.