Dr. Thomas Chi describes the key skills required to utilizing ultrasound-guided renal access for PCNL. He discusses the key elements to optimizing renal imaging and orienting yourself to anatomical landmarks, as well as needle control, including placement and puncture. Dr. Chi provides tips and tricks to improving imaging and needle skills, and method for overcome the learning curve to utilizing ultrasound.
Dr. Thomas Chi discusses the use of ultrasound-guided renal access for PCNL in two different case presentations – one patient in prone and another in supine position. For each patient position, Dr. Chi describes identification of important anatomical landmarks for image orientation and his technique for calyx targeting and stone identification. Dr. Chi closes with his method for utilizing ultrasound guided renal tract dilation.
Ultrasound guided access is the primary technique for PCNL in China and has been for over a decade. Dr. Li, who has conducted over 20,000 x-ray free PCNLs with his team since 2004, shares the case of a middle-aged male with bilateral staghorn stones and severe spinal deformity. Dr. Li explains how ultrasound guided PCNL access helped to mitigate potential injury for this particular case.
Dr. Seth Bechis discusses a percutaneous approach to treating a 52-year-old patient with a large 4cm obstructed proximal ureteral stone.
Dr. Krambeck discusses a percutaneous nephrolithotomy procedure in a 54-year-old woman with a large upper pole stone completely obstructing the upper pole system.
In this video, Bodo Knudsen, MD, of The Ohio State University Wexner Medical Center, Columbus, explains his step-by-step process for obtaining percutaneous access in stone patients.
Dr. Kaplan discusses the advantages of robotic surgery in urology, and presents a hard-to-reach complex stone location for which a robotic approach is warranted. He describes the step-by-step technique to perform a robotic-assisted nephrolithotomy and calyceal diverticulectomy in a 65-year-old patient with a 2.4 cm right renal stone.
The Painters also answer coding questions regarding prostate needle biopsy and InterStim.
Dr. Dangle shows that pediatric ureteroscopy is safe and feasible with good results and without long-term sequelae on the ureters.
This video shows a case of semi-rigid ureteroscopy with laser lithotripsy for ureteral stone in a child, who is rendered stone free without pre-stenting.