The "Alloun" Maneuver: A New Technique for Repositioning Difficult-To-Access Renal Stones During Endoscopic Treatment

Flexible renoureteroscopy and percutaneous nephroscopy are both the gold standards to treat kidney stones. The success rate of these techniques depends mainly on the location of the stone. In some challenging positions, access to the stone is impossible, indicating the failure of the whole procedure. Striving to access a stone in a challenging position can expose the endoscope to a high level of torsion that can damage it. We propose a new technique of stone repositioning applicable during percutaneous nephrolithotomy or flexible ureteroscopy using a laser fiber of any diameter. This technique is particularly useful when the stone is only partially accessible. We have developed this simple, easy, and cost-effective trick to minimize our rate of procedure failure and to prevent material forced torsion.