[VS-045]

Ultra-mini-percutaneous Nephrolithotomy in modified lithotomy position

¹Urology department, Henri-Mondor Hospital, 94010 Créteil Cedex, Paris, France.
²Urology Department, Airedale General Hospital., Keighley, West Yorkshire, UK BD20 6TP.
³Urology Department, Samved Hospital, Ahmedabad 380009, India.

Objectives
In an effort to diminish the morbidity of PCNL, miniaturization of instruments has been proposed with the aim of reducing renal parenchymal trauma. In this video we present ultra-mini-percutaneous nephrolithotomy (UMP).
Material and Methods
The UMP set consists of a telescope of 1mm in diameter and 17.000 optical fibers. It is fitted into an inner sheath which comes in two sizes: 7.5 and 6 Fr. The outher sheath (or Amplatz sheath) is also available in two sizes: 13Fr and 11Fr. This outher sheath has a side port, which connects to a very fine tube, which runs parallel inside the sheath and create a waterjet at the tip. After creating the percutaneous tract with ultrasound and fluoroscopy guidance, the stone is fragmented with a 272µm laser fiber. The laser is set to dusting mode i.e 0.5 Joules and 30Hz. After fragmentation, the fragments are removed with the waterjet. It produces a whirlpool inside the collecting system agitating the fragments and washes them out due to the pressure gradient.
Results
UMP is a viable option for the treatment of medium sized stones preferentially located in the lower calyx or renal pelvis. It is a usefull adjunct in case of failure of other treatment modalities such as ESWL or retrograde intrarenal surgery. The equipment is robust and cost effective. It helps to reduce the morbidity of percutaneous nephrolithotomy.
Conclusion
UMP is a further step in the miniaturization of PCNL allowing to minimize tissue trauma to the patient. This novel technique enriches the armamentarium of stone surgery.

---

Ultra-mini-percutaneous Nephrolithotomy in modified lithotomy position

Andras Hoznek¹, Mohammad Hassan Khan², Julie Rode¹, Janak Desai³, Alaxandre De La Taille^1
1Urology department, Henri-Mondor Hospital, 94010 Créteil Cedex, Paris, France.
²Urology Department, Airedale General Hospital., Keighley, West Yorkshire, UK BD20 6TP.
³Urology Department, Samved Hospital, Ahmedabad 380009, India.

Objectives
In an effort to diminish the morbidity of PCNL, miniaturization of instruments has been proposed with the aim of reducing renal parenchymal trauma. In this video we present ultra-mini-percutaneous nephrolithotomy (UMP).
Material and Methods
The UMP set consists of a telescope of 1mm in diameter and 17.000 optical fibers. It is fitted into an inner sheath which comes in two sizes: 7.5 and 6 Fr. The outher sheath (or Amplatz sheath) is also available in two sizes: 13Fr and 11Fr. This outher sheath has a side port, which connects to a very fine tube, which runs parallel inside the sheath and create a waterjet at the tip. After creating the percutaneous tract with ultrasound and fluoroscopy guidance, the stone is fragmented with a 272µm laser fiber. The laser is set to dusting mode i.e 0.5 Joules and 30Hz. After fragmentation, the fragments are removed with the waterjet. It produces a whirlpool inside the collecting system agitating the fragments and washes them out due to the pressure gradient.
Results
UMP is a viable option for the treatment of medium sized stones preferentially located in the lower calyx or renal pelvis. It is a usefull adjunct in case of failure of other treatment modalities such as ESWL or retrograde intrarenal surgery. The equipment is robust and cost effective. It helps to reduce the morbidity of percutaneous nephrolithotomy.
Conclusion
UMP is a further step in the miniaturization of PCNL allowing to minimize tissue trauma to the patient. This novel technique enriches the armamentarium of stone surgery.

---

0101

0101

Ultra-mini-percutaneous Nephrolithotomy in modified lithotomy position

Ultra-mini-percutaneous Nephrolithotomy in modified lithotomy position