Scholarlink

Objective <p>To report our initial experience using a simple principle that helps&#xa0;mini-endoscopic relocation of the guidewire into renal pelvis, ureter or upper calyx to improve percutaneous nephrolithotomy (PNL) puncture efficacy and enable safe dilatation.</p> Methods <p>A hydrophilic guidewire (sensor) was introduced through the access needle to calyx with a casting stone. 8 F Alken guide rod was passed over the guidewire followed by serial dilatation until the 4th Alken dilator (18F). Mini-perc outer sheath (18 F) was passed over under fluoroscopic guidance. A 8/11 Fr semirigid ureteroscope was progressed through the mini-perc sheath. A second sensor guidewire was passed, negotiated at the side of the stone to run through the infundibulum and renal pelvis down to the ureter or up to upper calyx under direct ureteroscopic vision. Routine tract dilatation by sequential rigid Alken metal dilators was done to enlarge the tract to 30 Fr.</p> Results <p>Our technique was employed on 14 (23%) out of 61 cases of PNL. Mean patient age was 47.5 yrs. Average stone size was 4.3&#xa0;cm. Mean mini-endoscopic time taken to relocate the guidewire into the ureter or upper calyx was 63&#xa0;s. Mini-endoscopic fluoroscopy time from introduction of ureteroscope to passage of sensor guidewire into ureter or upper calyx was 7.7&#xa0;s. No mini-endoscopic access complication reported.</p> Conclusion <p>The mini-endoscopic access directs and facilitates initial percutaneous access and dilatation safely with reducing radiation exposure. Technique novelty is due to being a simple, safe, effective, economic and benefit in simplifying the early learning curve of PNL.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Mini-endoscopic guided access: a simple principle for relocating the guidewire into the pelvicalyceal system for safe percutaneous nephrolithotomy

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年3月12日

查看全文
  • Fouad Zanaty,
  • Ibrahim Mowafy Gomaa,
  • Ahmed Gamal,
  • Mohamed Elgharbawy

摘要

Objective

To report our initial experience using a simple principle that helps mini-endoscopic relocation of the guidewire into renal pelvis, ureter or upper calyx to improve percutaneous nephrolithotomy (PNL) puncture efficacy and enable safe dilatation.

Methods

A hydrophilic guidewire (sensor) was introduced through the access needle to calyx with a casting stone. 8 F Alken guide rod was passed over the guidewire followed by serial dilatation until the 4th Alken dilator (18F). Mini-perc outer sheath (18 F) was passed over under fluoroscopic guidance. A 8/11 Fr semirigid ureteroscope was progressed through the mini-perc sheath. A second sensor guidewire was passed, negotiated at the side of the stone to run through the infundibulum and renal pelvis down to the ureter or up to upper calyx under direct ureteroscopic vision. Routine tract dilatation by sequential rigid Alken metal dilators was done to enlarge the tract to 30 Fr.

Results

Our technique was employed on 14 (23%) out of 61 cases of PNL. Mean patient age was 47.5 yrs. Average stone size was 4.3 cm. Mean mini-endoscopic time taken to relocate the guidewire into the ureter or upper calyx was 63 s. Mini-endoscopic fluoroscopy time from introduction of ureteroscope to passage of sensor guidewire into ureter or upper calyx was 7.7 s. No mini-endoscopic access complication reported.

Conclusion

The mini-endoscopic access directs and facilitates initial percutaneous access and dilatation safely with reducing radiation exposure. Technique novelty is due to being a simple, safe, effective, economic and benefit in simplifying the early learning curve of PNL.