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Revista mexicana de urología
On-line version ISSN 2007-4085Print version ISSN 0185-4542
Abstract
ARELLANO-CUADROS, José Rodrigo; PINEDA-MURILLO, Javier; TORRES-AGUILAR, Jesús and SANDOVAL-SALAZAR, Ana Fátima R.. Percutaneous nephrolithotomy: implementation of digital insertion and dissection as an adjunct to the technique. Rev. mex. urol. [online]. 2018, vol.78, n.3, pp.202-206. Epub June 25, 2021. ISSN 2007-4085. https://doi.org/10.24245/revmexurol.v78i3.1834.
BACKGROUND:
Percutaneous nephrolithotomy (PCNL) was established as a minimally invasive treatment option for kidney stones in the 1970s and is considered a safe and effective procedure, with stone clearance rates of 78-95%. The ideal puncture should maximize the effectiveness of the procedure in terms of stone-free status and minimize the risk of complications.
CLINICAL CASE:
We present the case of a 36-year-old male patient with bilateral lower back pain. A CT urography scan was performed that revealed bilateral lithiasis. The stone on the right side was consistent with an incomplete staghorn stone and a right retrorenal colon was identified. Left flexible nephrolithotripsy and subsequent right percutaneous nephrolithotomy were performed. A puncture was made under fluoroscopic guidance supported by previous digital dissection of all layers of the abdominal wall until gaining access to the retroperitoneum. Colonic lesion was prevented and a tunnel through which the renal unit could be palpated was formed.
CONCLUSIONS:
The technique of digital insertion and dissection offers safe access to the renal unit that is useful in patients presenting with risk factors for a potential complication.
Keywords : Digital; Kidney; Lithiasis; Percutaneous nephrolithotomy.
