Percutaneous Nephrolithotomy Access: A Systematic Review of Intraoperative Assistive Technologies

Nguyen, David‐Dan; Luo, Jack W.; Tailly, Thomas; Bhojani, Naeem

doi:10.1089/end.2019.0085

Cited by 9 publications

(3 citation statements)

References 45 publications

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“…The use of PCNL has dramatically improved the outcome of complex stones, and the establishment of an ideal percutaneous renal access is a crucial step. 15 The optimal access should have a short distance from the skin to the calyx dome and should allow for reaching most of the target calyxes. The middle or upper calyx of the dorsal kidney is the preferred site for puncture, and ultrasound-guided puncture of the calyx dome facilitates reduction of surgical bleeding and efficient stone clearance.…”

Section: Discussionmentioning

confidence: 99%

Learning curve of ultrasound-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi

Lu,

Yang,

2024

J Int Med Res

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Objective This study was performed to investigate the learning curve of ultrasound-guided percutaneous nephrolithotripsy (PCNL) for the treatment of complex renal calculi. Methods Seventy-two patients with complex renal stones who underwent ultrasound-guided PCNL by the same operator from November 2016 to September 2020 were retrospectively analyzed. The learning curve of PCNL for complex renal stones was analyzed using multifactorial cumulative sum (CUSUM) analysis and best-fit curves. Results The CUSUM best-fit curve peaked at Case 36, which represented the minimum number of cumulative cases required to cross the learning curve for this surgical procedure. Accordingly, the learning curve was divided into a learning improvement period (36 cases) and a proficiency phase (36 cases). Compared with the learning improvement period, the proficiency phase was characterized by a shorter puncture time and operation time, a smaller drop in the hemoglobin level, and a lower postoperative complication rate. Conclusion The learning curve of PCNL for the treatment of complex renal calculi can be divided into a learning improvement period and a proficiency phase, and the minimum cumulative number of cases is 36.

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Section: Discussionmentioning

confidence: 99%

Learning curve of ultrasound-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi

Lu,

Yang,

2024

J Int Med Res

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“…[48] Many different strategies have been utilized like use of I pad, electromagnetic tracking device, use of laser-guided Dyna computed tomography, and many others to ease the learning curve and make the procedure more efficacious. [49] Mathematical principles have been used to calculate the access point, direction, and depth of puncture. [325051]…”

Section: Future Of Percutaneous Renal Accessmentioning

confidence: 99%

Techniques for fluoroscopy-guided percutaneous renal access: An analytical review

Sharma¹,

Luitel

2019

Indian J Urol

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Percutaneous renal access is a key step for a successful percutaneous nephrolithotomy. It involves the use of fluoroscopy, ultrasonography, or a combination of both. Over the years, various techniques have been proposed for fluoroscopy-guided access, and this article reviews the different techniques along with the anatomical principles for fluoroscopy-guided percutaneous renal access. A literature search was performed using “PubMed” for relevant literature describing the various techniques for fluoroscopy-guided percutaneous renal access. Each technique was analyzed in regard to how it describes selecting the skin site for puncture and determines the angle and depth of puncture. The advantages, limitations, and variations of these techniques were also studied. Each technique has its advantages and limitations. No study has compared all the techniques either in vivo or in vitro. Only a comparative study would establish the superiority of one technique over the other. Until this is done, endourologists should be well versed with the existing techniques.

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“…This is a standard opening remark of many publications [1][2][3]. Several reviews on the puncture and intraoperative assistive technologies have been published in recent years [2][3][4][5]. They concentrate on technical details but rarely on data dealing with procedural details, problems, and pitfalls of the puncture.…”

Section: Introduction and Search Strategymentioning

confidence: 99%

Percutaneous nephrolithotomy – the puncture

Alken

2021

BJU International

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ObjectiveTo determine what importance is given to the puncture and assistive technologies in percutaneous nephrolithotomy (PNL) in the current urological literature. MethodsPubMed was searched for English publications and reviews for the keywords: 'percutaneous nephrolithotomy', 'percutaneous nephrostomy', 'puncture'. The search was limited to the last 5 years, January 2016 until February 2021. Based on 183 abstracts, 121 publications were selected, read, and reviewed. References, older or seminal papers were read and cited if they contributed to a better understanding. A total of 198 references form the basis of this narrative review. ResultsThe puncture is frequently referred to as the most crucial part of PNL. In contrast, the influence of the puncture on the failure rate of PNL and the specific puncture-related complications seems to be low in the single-digit percentage range. However, there are no universally accepted definitions and standards measuring the quality of puncture. Consequently, the impact of the puncture on general PNL complications, on stone scores predicting success rates and on learning curves evaluating surgeons' performance have not been systematically studied. Assistive technologies rely on fluoroscopy and ultrasonography, the latter of which is becoming the preferred imaging modality for monitoring the entire procedure. Needle bending, a problem relevant to all puncture techniques, is not addressed in the urological literature. ConclusionsThe importance attached to puncture in PNL in the current urological literature is subjectively high but objectively low. Some basics of puncture are not well understood in urology. Disciplines other than urology are more actively involved in the development of puncture techniques.

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Percutaneous Nephrolithotomy Access: A Systematic Review of Intraoperative Assistive Technologies

Cited by 9 publications

References 45 publications

Learning curve of ultrasound-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi

Learning curve of ultrasound-guided percutaneous nephrolithotripsy in the treatment of complex renal calculi

Techniques for fluoroscopy-guided percutaneous renal access: An analytical review

Percutaneous nephrolithotomy – the puncture

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