title: A technique to flush out renal stone fragments during percutaneous nephrolithotomy.
abstract: There are a number of graspers and baskets to snare and remove stones during percutaneous nephrolithotomy (PCNL). These instrumental techniques can, however, cause inadvertent trauma to the renal mucosa and can be time consuming. Increasingly, these graspers and baskets are disposable, which also has financial implications. We use a simple technique to flush out fragments from the kidney during PCNL. Once fragments have been identified as a size that can pass through the Amplatz sheath, a cut nasogastric tube is inserted through the sheath--if possible next to or behind the fragments. It is repeatedly moved forward and backward in a jerking motion while saline is instilled under some pressure to create some turbulence. This results in the mechanical flushing out of stone fragments. We have found this to be a safe, effective, and reliable technique of stone extraction during PCNL.
authors.affiliation: Department of Urology, Bart's and The London NHS Trust, London, United Kingdom.
authors.forename: Ali
authors.initials: A
authors.lastname: Panah
authors.forename: Junaid
authors.initials: J
authors.lastname: Masood
authors.forename: Faruquz
authors.initials: F
authors.lastname: Zaman
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Papatsoris
authors.forename: Tamer
authors.initials: T
authors.lastname: El-Husseiny
authors.forename: Noor
authors.initials: N
authors.lastname: Buchholz
mesh_terms: D006801:Humans; D007669:Kidney Calculi / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000379:methods*