Open AccessA Technique to Flush Out Stone Fragments Through a Ureteral Access Sheath During Retrograde Intrarenal Surgery
Author(s) -
Shlomi Tapiero,
Peter Ghamarian,
Ralph V. Clayman
Publication year - 2019
Publication title -
journal of endourology case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.123
H-Index - 1
ISSN - 2379-9889
DOI - 10.1089/cren.2019.0059
Subject(s) - medicine , kidney stones , surgery , foley catheter , ureteroscopy , clearance , catheter , urology , ureter
Background: Retrograde intrarenal surgery (RIRS) has become the preferred treatment option for selected renal stones <20 mm. However, laser fragmentation of stones often results in residual small fragments that may prompt subsequent stone events. We describe a simple technique to facilitate removal of these fragments. Case Presentation: A 68-year-old woman underwent elective RIRS for a 13 mm right renal pelvic stone. After laser fragmentation of the stone there were numerous <2 mm fragments too small to allow removal by a standard retrieval basket (i.e., NCircle ® and NCompass ® Nitinol Stone Extractors, Cook Medical, Bloomington, IN). A smaller ureteral access sheath (UAS) was advanced into the kidney within the preexisting larger UAS and, using a connecting piece from a Foley catheter, stone fragments were suctioned out through the smaller sheath. Stone-free status was corroborated endoscopically and with postoperative CT. Conclusion: Stone fragments were flushed from the kidney using a simple irrigation technique through a coaxial UAS.