title: Ultrasound-Guided Renal Access for Percutaneous Nephrolithotomy: A Description of Three Novel Ultrasound-Guided Needle Techniques.
abstract: Ultrasound-guided renal access for percutaneous nephrolithotomy (PCNL) is a safe, effective, and low-cost procedure commonly performed worldwide, but a technique underutilized by urologists in the United States. The purpose of this article is to familiarize the practicing urologist with methods for ultrasound guidance for percutaneous renal access. We discuss two alternative techniques for gaining renal access for PCNL under ultrasound guidance. We also describe a novel technique of using the puncture needle to reposition residual stone fragments to avoid additional tract dilation. With appropriate training, ultrasound-guided renal access for PCNL can lead to reduced radiation exposure, accurate renal access, and excellent stone-free success rates and clinical outcomes.
authors.affiliation: 1 Department of Urology, University of California , San Francisco, California.
authors.forename: Carissa
authors.initials: C
authors.lastname: Chu
authors.affiliation: 1 Department of Urology, University of California , San Francisco, California.
authors.forename: Selma
authors.initials: S
authors.lastname: Masic
authors.affiliation: 1 Department of Urology, University of California , San Francisco, California.|2 Division of Urology, Chulalongkorn University , Bangkok, Thailand .
authors.forename: Manint
authors.initials: M
authors.lastname: Usawachintachit
authors.affiliation: 3 Department of Urology, Beijing Tsinghua Changgung Hospital , Beijing, People's Republic of China .
authors.forename: Weiguo
authors.initials: W
authors.lastname: Hu
authors.affiliation: 4 The Affiliated Hospital of Hebei University , Baoding, Hebei, People's Republic of China .
authors.forename: Wenzeng
authors.initials: W
authors.lastname: Yang
authors.affiliation: 1 Department of Urology, University of California , San Francisco, California.
authors.forename: Marshall
authors.initials: M
authors.lastname: Stoller
authors.affiliation: 3 Department of Urology, Beijing Tsinghua Changgung Hospital , Beijing, People's Republic of China .
authors.forename: Jianxing
authors.initials: J
authors.lastname: Li
authors.affiliation: 1 Department of Urology, University of California , San Francisco, California.
authors.forename: Thomas
authors.initials: T
authors.lastname: Chi
mesh_terms: D006801:Humans; D007668:Kidney / Q000000981:diagnostic imaging / Q000601:surgery*; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D009339:Needles; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011677:Punctures / Q000379:methods; D000069079:Radiation Exposure; D025321:Surgery, Computer-Assisted / Q000379:methods*; D014463:Ultrasonography