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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.