PCNL

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Patient Information

  • 53yo, DM (A1c:6.0), HTN
  • 3cm R UVJ, L 1.7cm lower pole, 1578 HU, SSD 10.5cm
  • UCx negative

Pre-op Diagnosis

  1. Left Renal calculus <2cm
  2. Hx of R hydronephrosis
  3. Bilateral flank pain

Procedures Performed

  1. Left Percutaneous ultrasonic nephrolithotripsy approximately 2cm, tubeless
  2. Dilation and establishment of a percutaneous access tract
  3. Antegrade placement of firm double-J ureteral stent
  4. Antegrade nephrostogram
  5. Fluoroscopy <1hr
  6. Images interpreted by MD
  7. Placement of Foley by MD

Required Equipment

  1. 16F Foley
  2. Omnipaque contrast
  3. Sensor wire
  4. Super stiff wire
  5. Dual lumen catheter
  6. 11 blade
  7. Curved hemostat
  8. Nephrostomy dilation balloon 30F
  9. Nephroscope (non-obese) (ensure clear lens)
  10. Lithotriptor
  11. Lithotripter probe (on and working)
  12. Laser
  13. Laser fiber 270 (setting of 1.4J x 6Hz for fragment, 0.3J x 70Hz for dusting) given dense stone
  14. Cystoscope
  15. 5Fr open ended catheter
  16. Cook 6F x 24cm firm double J stent
  17. Additional 20F foley catheter
  18. Kaye nephrostomy tamponade balloon