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Description keyboard_arrow_down
Retrograde and antegrade combined access to the collecting system, with both rigid and flexible scopes. Procedure steps: · Cystoscopy for left JJ removal · Semirigid ureteroscopy · Digital flexible ureteroscopy · US-oriented, fluoroscopy-guided and Endovision-controlled percutaneous puncture · Tract dilation (fascial dilators and balloon), Amplatz sheath insertion 24 Ch · Combined (pneumatic and ultrasound lithotripsy), with litholapaxy with N-Perc and irrigation · Combined final exploration of all calyces · Final JJ stenting and 8Ch pyelostomy closed, catheter Learning Points · The combined use of rigid and flexible scopes · The combined use of the retrograde and antegrade approaches · The diagnostic (and active) role of retrograde flexible ureteroscopy How to improve efficacy and safety of the percutaneous procedure

Clinical Case:

  • 54-year-old female patient
  • ASA II, no allergies, no smoke
  • 91.0 kg, 160cm, BMI 35.5
  • Left 2 cm pyelic stone with double JJ stent and 36% function


Clinical History:

  • 02/2018 recurrent left lumbar pain
  • Access to the Emergency Department
  • US = left kidney stone
  • NCCT = left 2 cm pyelic stone with hydronephrosis
  • Left JJ inserted
  • Renal scintigraphy = right 64%, left 36%


Other:

  • One caesarean delivery
  • Tonsillectomy
  • Hysteroannessiectomy
  • Thyroidectomy for cancer followed by radioactive iodine therapy
  • Two herniated lumbar discs
  • Autoimmune arthritis
  • Chronic kidney failure (creatinine 1.75 mg/dl)
Faculty keyboard_arrow_down
Dr. Cesare M. Scoffone Head, Depart.of Urology, Cottolengo Hospital, Torino, Italy Urology
Dr. Cecilia M. Cracco MD, PHD, Urologist, Urology Department, Cottolengo Hospital, Torino, Italy Urology
Devices keyboard_arrow_down
+ More Info NephroMax™ High Pressure Nephrostomy Balloon Catheter
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