title: Percutaneous puncture of renal calyxes guided by a novel device coupled with ultrasound.
abstract: OBJECTIVE
  To evaluate the efficiency of a novel device coupled with ultrassound for renal percutaneous puncture.
  
  
  METHODS
  After establishing hydronephrosis, ten pigs had three calyxes of each kidney punctured by the same urology resident, with and without the new device ("Punctiometer"). Time for procedure completion, number of attempts to reach the calyx, puncture precision and puncture complications were recorded in both groups and compared.
  
  
  RESULTS
  Puncture success on the first attempt was achieved in 25 punctures (83%) with the Punctiometer and in 13 punctures (43%) without the Punctiometer (p=0.011). The mean time required to perform three punctures in each kidney was 14.5 minutes with the Punctiometer and 22.4 minutes without the Punctiometer (p=0.025). The only complications noted were renal hematomas. In the Punctiometer group, all kidneys had small hematomas. In the no Punctiometer group 80% had small hematomas, 10% had a medium hematoma and 10% had a big hematoma. There was no difference in complications between both groups.
  
  
  CONCLUSIONS
  The Punctiometer is an effective device to increase the likelihood of an accurate renal calyx puncture during PCNL, with a shorter time required to perform the procedure.
authors.affiliation: Seção de Endorologia e Videolaparoscopia, Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Escola de Medicina, São Paulo, Brasil.
authors.forename: Chen Jen
authors.initials: CJ
authors.lastname: Chan
authors.affiliation: Seção de Endorologia e Videolaparoscopia, Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Escola de Medicina, São Paulo, Brasil.
authors.forename: Victor
authors.initials: V
authors.lastname: Srougi
authors.affiliation: Seção de Endorologia e Videolaparoscopia, Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Escola de Medicina, São Paulo, Brasil.
authors.forename: Fabio Yoshiaki
authors.initials: FY
authors.lastname: Tanno
authors.affiliation: Seção de Endorologia e Videolaparoscopia, Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Escola de Medicina, São Paulo, Brasil.
authors.forename: Ricardo Duarte
authors.initials: RD
authors.lastname: Jordão
authors.affiliation: Seção de Endorologia e Videolaparoscopia, Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Escola de Medicina, São Paulo, Brasil.
authors.forename: Miguel
authors.initials: M
authors.lastname: Srougi
mesh_terms: D000818:Animals; D004867:Equipment Design; D007670:Kidney Calices / Q000601:surgery*; D023421:Models, Animal; D009403:Nephrostomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D011677:Punctures / Q000295:instrumentation* / Q000379:methods; D011897:Random Allocation; D015203:Reproducibility of Results; D013552:Swine; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000295:instrumentation* / Q000379:methods