title: Determining site of skin puncture for percutaneous renal access using fluoroscopy-guided triangulation technique.
abstract: OBJECTIVE
  The purpose of this study is to describe a technique to determine the site of skin puncture for sub-costal percutaneous renal access using a fluoroscopy-guided triangulation technique.
  
  
  METHODS
  Using the bull's-eye technique under fluoroscopy guidance, the distance of skin puncture from the targeted calyx is determined. Then this distance is utilized in the triangulation technique to determine the site of skin puncture. Since July 2007 to February 2008, 30 cases were done using this technique.
  
  
  RESULTS
  Successful access was accomplished in all cases in alignment with the infundibulum. Lower pole access was achieved in 21 cases and midpole access was achieved in 9 cases.
  
  
  CONCLUSIONS
  This technique helps to determine the correct site of skin puncture in the fluoroscopy-guided triangulation technique. It leads to a tract that is of optimum length, proper direction, and is in alignment with the infundibulum.
authors.affiliation: Urology Department, Chitale Clinic Pvt. Ltd., Solapur, Maharashtra, India. drgrsharma@aol.com
authors.forename: Gyanendra
authors.initials: G
authors.lastname: Sharma
authors.forename: Anshu
authors.initials: A
authors.lastname: Sharma
mesh_terms: D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging*; D007670:Kidney Calices / Q000000981:diagnostic imaging; D011677:Punctures; D012867:Skin / Q000000981:diagnostic imaging*