Open Access
Prone percutaneous nephrolithotomy: its advantages and our technique for puncture
Author(s) -
Diego M Carrión,
José R. Cansino,
Luis Miguel Quintana,
Juan Gómez Rivas,
J.A. Mainez Rodríguez,
J.R. Pérez-Carral,
Luis MartínezPiñeiro
Publication year - 2018
Publication title -
translational andrology and urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.721
H-Index - 27
eISSN - 2223-4691
pISSN - 2223-4683
DOI - 10.21037/tau.2018.10.04
Subject(s) - percutaneous nephrolithotomy , supine position , medicine , prone position , fluoroscopy , percutaneous , surgery , urinary system , radiology
Percutaneous nephrolithotomy (PCNL) is considered the treatment of choice for large urinary calculi and staghorn lithiasis. The approach for this surgery may be either supine or prone, and different access techniques are described in the literature with the use of ultrasound, fluoroscopy, or both combined. We believe that prone PCNL offers to the urologist key advantages, such as the possibility of puncturing anatomically abnormal urinary tracts, to perform multiple percutaneous tracts in the same kidney, experiencing the vacuum cleaner effect, ease of exploring the upper calyx through the inferior calyx, possibility to perform endoscopic combined intrarenal surgery (ECIRS) and bilateral simultaneous surgery, and to performed over local anesthesia. An adequate training for the endourologist should include both the prone and supine techniques for PCNL and to know which patient can benefit the most from each one.