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Current Urology Reports

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01.04.2021 | Surgery (M Desai, Section Editor)

Precision Stone Surgery: Current Status of Miniaturized Percutaneous Nephrolithotomy

verfasst von: John M. DiBianco, Khurshid R. Ghani

Erschienen in: Current Urology Reports | Ausgabe 4/2021

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Abstract

Purpose of Review

Innovations in lasers and surgical technology have led to a renewed interest in the miniaturization of percutaneous nephrolithotomy (PCNL). We review the different approaches and evidence on the efficacy of mini-PCNL.

Recent Findings

Mini-PCNL encompasses a range of techniques using tract sizes from 4.8 to 22 F to treat renal stones. The most common device uses irrigation to passively extract stones out of the sheath. Super-mini-PCNL incorporates active suction. Ultra- and micro-techniques reduce the tract to smaller diameters. Laser fragmentation is the main lithotripsy modality. Studies demonstrate an association with reduced complications, hospital stay, and increased tubeless rate. Drawbacks include longer operative times while stone-free rates for larger stones may be sub-optimal.

Summary

Mini-PCNL has advantages of less trauma and the avoidance of nephrostomy tubes. Ambulatory surgery is feasible in select patients. Advances in laser lithotripsy and active suction have the potential to improve stone clearance and treat larger stones.

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Titel: Precision Stone Surgery: Current Status of Miniaturized Percutaneous Nephrolithotomy
verfasst von: John M. DiBianco
Khurshid R. Ghani
Publikationsdatum: 01.04.2021
Verlag: Springer US
Erschienen in: Current Urology Reports / Ausgabe 4/2021
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-021-01042-0

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Precision Stone Surgery: Current Status of Miniaturized Percutaneous Nephrolithotomy

Abstract

Purpose of Review

Recent Findings

Summary

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