"Blind coning"--using the Stone Cone for removal of intramural ureteral calculi.
BACKGROUND
To describe the otherwise heretical technique of "blind" nonureteroscopic extraction of calculi from the intramural ureter using a 7-mm-diameter tapered coil called the "Stone Cone."


METHODS
After bypassing the stone and deploying the Stone Cone, slow traction was exerted. The Stone Cone's 5, 6, and 7-mm diameter coils and unique rotary action dilated the tunnel distal to the calculus and the 2, 3, and 4-mm stiffer coils caught the calculus and propelled it out of the transiently dilated intramural ureter. A safety feature is that the coils of the Stone Cone will unwind at greater than 0.2-lb tension. Unlike the baskets, if a pressure greater than this is encountered, the Stone Cone will release the stone, preventing entrapment.


CONCLUSIONS
In selected cases, use of the Blind-Cone to remove an intramural calculus can be a rapid, effective, and safe alternative to ureteroscopic management.
Eisner
Brian H
BH
Kidney Stone Center, Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. beisner@partners.org
Feldman
Adam S
AS
Chapin
Brian F
BF
Dretler
Stephen P
SP
D004867:Equipment Design; D006801:Humans; D014514:Ureteral Calculi / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000295:instrumentation / Q000379:methods