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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.
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.