Ureteroscopic management of lower-pole renal calculi: Technique of calculus displacement

被引:57
作者
Auge, BK [1 ]
Dahm, P [1 ]
Wu, NZ [1 ]
Preminger, GM [1 ]
机构
[1] Duke Univ, Med Ctr, Div Urol, Dept Surg,Comprehens Kidney Stone Ctr, Durham, NC 27710 USA
关键词
D O I
10.1089/089277901753205852
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: We review our technique of ureteroscopic management of lower pole renal calculi with Nitinol basket displacement and holmium laser stone fragmentation. Methods: Lower pole calculi are identified with a 7.5F flexible ureteroscope. In patients in whom the laser fiber reduces ureteroscopic deflection, precluding reentry into the lower pole, a Nitinol basket or grasper is used to displace the calculi into an upper pole calix for easier fragmentation. Results: The Nitinol device can be passed into the lower pole through the fully deflected ureteroscope without any loss of deflection. Irrigation is significantly reduced by the basket, but this factor does not impede stone retrieval. Conclusions: Ureteroscopic management of lower pole stones is a reasonable alternative to SWL or percutaneous nephrolithotomy in low-volume stone disease. If the stone cannot be fragmented in situ, Nitinol basket capture through a fully deflected ureteroscope into a less dependent position facilitates stone fragmentation.
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收藏
页码:835 / 838
页数:4
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