Innovations in percutaneous nephrolithotomy.
Technical innovations in all aspects of percutaneous nephrolithotomy have changed the field considerably. The current review is aimed at reporting on the most recent advancements in the field of percutaneous nephrolithotomy. Improvements in CT imaging and the possibility of 3D rendering have dethroned the intravenous pyelogram as gold standard for pre-operative imaging. Where gaining access in the lower pole in prone position with telescopic metal dilators, placing a 30F tract used to be standard, the plethora of alternatives provides the trained surgeon with a large armamentarium to tackle any obstacle. Novel lithotripters appear more efficient than their predecessors and with tubeless PCNL gaining some momentum, ambulatory PCNL is slowly but surely becoming feasible rather than fictional.
Department of Urology, University Hospital Ghent, De Pintelaan 182, 9000 Gent, Belgium. Electronic address: thomas.tailly@uzgent.be.
Thomas
T
Tailly
Department of Surgery, Division of Urology, Western University, St. Joseph's Health Care, 268 Grosvenor St., London, Ontario N6A 4V2 Canada. Electronic address: john.denstedt@sjhc.london.on.ca.
John
J
Denstedt
D002983:Clinical Competence; D006801:Humans; D007669:Kidney Calculi / Q000175:diagnosis / Q000601:surgery*; D009403:Nephrostomy, Percutaneous / Q000639:trends*; D066231:Surgeons / Q000592:standards*; D025321:Surgery, Computer-Assisted / Q000379:methods*
Computed tomography; Lithotripter; Miniaturized percutaneous nephrolithotomy; Percutaneous nephrolithotomy; Three-dimensional; Tubeless; Ultrasound