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- W3021036369 abstract "INTRODUCTION AND OBJECTIVE: Percutaneous NephroLithotomy (PCNL) access to the kidney is performed, to date, mostly under X-Ray fluoroscopy. Providing only a 2D image, sometimes includes multiple puncture trials and exposes the patient and staff to ionizing radiation. The same access can be achieved under ultrasound (US) guidance, without radiation exposure and with similar success rate in expert hands. We present some of the important benefits of using US-guidance, to advocate for further utilization of the technique. METHODS: A review of literature was conducted on benefits of US-guided PCNL access. Live operating room images and videos were collected, with the help of leading endourologists, to demonstrate various techniques and special circumstances when US imaging may be crucial for the success of the procedure. RESULTS: Other than the obvious reduction of radiation exposure to both the patient and surgeon, we show the rocking, skiing and fanning techniques that help understand the 3D anatomy of the kidney and collecting system. Using US-guidance is more precise in targeting a specific calyx and controlling the desired trajectory, with less puncture attempts and possible less intra-operative bleeding.One can plan his access and avoid complications by utilizing office-based US pre-operatively, this may prove very important in patients planned for a prone position PCNL with a supine computed tomography(CT) scan.Different anatomic variants and special cases demonstrate the importance of US imaging; those include patients with ectopic or transplant kidneys, mobile colon or enlarged liver and spleen, horse-shoe kidneys, and pregnant patients. CONCLUSIONS: We demonstrate some of the most important benefits of using US-guidance for PCNL access, and why everyone should try and utilize it in their practice. Source of Funding: none" @default.
- W3021036369 created "2020-05-13" @default.
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- W3021036369 date "2020-04-01" @default.
- W3021036369 modified "2023-09-25" @default.
- W3021036369 title "V04-04 ULTRASOUND-GUIDED PERCUTANEOUS NEPHROLITHOTOMY, YOU SHOULD DO IT TOO" @default.
- W3021036369 doi "https://doi.org/10.1097/ju.0000000000000863.04" @default.
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