title: A novel single step percutaneous access sheath: the initial human experience.
abstract: OBJECTIVE
  A novel 1-step percutaneous access sheath NS has been developed that allows the insertion of a dilating balloon and renal access sheath in a single step. We present the initial human experience with this sheath.
  
  
  METHODS
  We performed a retrospective chart and database review of the initial 30 consecutive patients undergoing percutaneous nephrostolithotomy using the NS. Data collected included patient demographics, operative and recovery parameters, and complications.
  
  
  RESULTS
  Mean patient age was 50.4 years (range 11 to 81), mean body mass index was 31.63 kg/m(2) (range 17.1 to 65) and mean preoperative stone area was 6.23 cm(2) (range 1 to 14.6). Six and 3 patients had full and partial staghorn calculi, respectively. Access was achieved via the upper pole in 16 patients, middle pole in 7 and lower pole in 7. Mean operative time was 114.8 minutes (range 61 to 237). Mean estimated blood loss was 145.5 cc (range 10 to 500) and mean postoperative hospital stay was 4.89 days (range 2 to 14). A total of 23 patients (76.7%) had no residual calculi on postoperative computerized tomography, 5 (16.7%) had residual fragments 4 mm or less and 2 (6.7%) had residual stone fragments greater than 4 mm. There were no complications related to the NS.
  
  
  CONCLUSIONS
  The NS is safe, easy to use and has potential advantages compared to currently available renal access sheaths.
authors.affiliation: Division of Urology, Loma Linda University Medical Center, Loma Linda, California, USA.
authors.forename: D Duane
authors.initials: DD
authors.lastname: Baldwin
authors.forename: Lincoln J
authors.initials: LJ
authors.lastname: Maynes
authors.forename: Premal J
authors.initials: PJ
authors.lastname: Desai
authors.forename: Forrest C
authors.initials: FC
authors.lastname: Jellison
authors.forename: Christopher K
authors.initials: CK
authors.lastname: Tsai
authors.forename: Gary R
authors.initials: GR
authors.lastname: Barker
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D004867:Equipment Design; D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation*; D012189:Retrospective Studies