Supine Percutaneous Nephrolithotomy and ECIRS

This book details Percutaneous nephrolithotomy (PNL), the gold standard for the surgical treatment of renal stones larger than 2 cm. It details the technique step by step, the instruments and accessories employed, and the organization of the operating room.

PNL is the gold standard for the management of large and/or otherwise complex renal stones. Since its introduction in the seventies PNL has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrument technology, lithotripsy devices and drainage management. The conventional prone position for PNL has been challenged in the last two decades by a variety of modifications, including the supine and Galdakao-modified supine Valdivia positions, which make simultaneous retrograde working access to the collecting system possible and have proven anesthesiological advantages. The Galdakao-modified supine Valdivia position allowed the development of ECIRS (Endoscopic Combined IntraRenal Surgery), a technique exploiting a combined antegrade and retrograde approach to the upper urinary tract, using both rigid and flexible endoscopes with the related accessories. The synergistic teamwork of ECIRS provides a safe and efficient, minimally-invasive procedure for the treatment of all kinds of urolithiasis.The aim of this book is to share with the urologic community worldwide our experience, our standardization of all the steps, and tips and tricks for the procedure.

First book dealing with supine PNL The supine position with its modifications is the basis for ECIRS (Endoscopic Combined Intra-Renal Surgery) This book describes in detail the surgical technique step by step, all the instruments and accessories to be employed, the organization of the operating room, the application of this surgical approach to special cases (malignant conditions, malformations, obesity, renal transplant) The preoperative assessment of the patient for a correct indication (anatomic study from radiological images), is analyzed It presents a wide preliminary revision of the recent literature with the current state of the art The authors propose numerous video-clips illustrating the written material All contributors are opinion leaders of the field of endourology

Autorentext
Drs. A. Hoznek and C. Scoffone have been collaborating for many years in the evaluation, presentation and teaching of the technique. They accumulated an important amount of pedagogic material. During their different workshops, they realized that there is a strong need for a reference book in the endourology field.

Inhalt

Introduction.- History of PNL.- Prone PNL: Review and results.- PNL Indications and guidelines.- Anatomy for PNL.- Radiology for stone disease.- Anesthesiological considerations (especially position related issues) before, during, after.- Supine PNL.- Endoscopic Combined Intrarenal surgery.- Technical aspects of percutaneous management of ureteral stenoses and upper urinary tract transitional cell carcinoma.- Complications: how to manage them?.- PNL in pediatric patient.- Results: published series.- Conclusions.