title: Fluoroscopy-guided renal access in supine percutaneous nephrolithotomy.
abstract: OBJECTIVE
  To describe a standardized and easily reproducible method for fluoroscopy-guided renal access during supine percutaneous nephrolithotomy (sPCNL).
  
  
  METHODS
  From January 2009 to January 2010, 35 patients underwent sPCNL. In 10 patients, ultrasound-guided puncture was unsuccessful. In these patients, we completed percutaneous access with a method based on fluoroscopy. We used a simple technique, adapted to sPCNL, consisting of cephalad tilting of the C-arm during puncture of the targeted calyx. We prospectively recorded the time necessary for the puncture, the success, and the complication rate of the puncture.
  
  
  RESULTS
  Among the 10 study patients, the mean operative time for the puncture was 50 seconds (range 35-180). The puncture was successful after 1 attempt in 7 patients and in the remaining patients after a second or a third attempt. There were no complications related to the puncture technique.
  
  
  CONCLUSIONS
  This technique is easy and reproducible for creating a fluoroscopy-guided renal access adjunctive to ultrasound during sPCNL. It may also be useful for urologists not familiar with ultrasound-guided access.
authors.affiliation: Service d'Urologie, Centre Hospitalier Universitaire Henri Mondor, Assistance Publique des Hôpitaux de Paris, Créteil, France.
authors.forename: András
authors.initials: A
authors.lastname: Hoznek
authors.forename: Idir
authors.initials: I
authors.lastname: Ouzaid
authors.forename: Matthew
authors.initials: M
authors.lastname: Gettman
authors.forename: Julie
authors.initials: J
authors.lastname: Rode
authors.forename: Alexandre
authors.initials: A
authors.lastname: De La Taille
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Clément-Claude
authors.initials: CC
authors.lastname: Abbou
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D056888:Patient Positioning / Q000379:methods*; D011446:Prospective Studies; D016683:Supine Position; D055815:Young Adult