Supine Percutaneous Nephrolithotomy and ECIRS. The New Way of Interpreting PNL

ABOUT THIS BOOK

• First book dealing with supine PNL
• The supine position with its modifications is the basis for ECIRS (Endoscopic Combined Intra-Renal Surgery)
• This book describes in detail the surgical technique step by step, all the instruments and accessories to be employed, the organization of the operating room, the application of this surgical approach to special cases (malignant conditions, malformations, obesity, renal transplant…)
• The preoperative assessment of the patient for a correct indication (anatomic study from radiological images), is analyzed
• It presents a wide preliminary revision of the recent literature with the current state of the art
• The authors propose numerous video-clips illustrating the written material
• All contributors are opinion leaders of the field of endo-urology

Percutaneous nephrolithotomy (PNL) is the gold standard for the surgical treatment of renal stones larger than 2 cm. This intervention was traditionally performed in two steps: ureteral catheterisation in lithotomy position and the rest of the procedure in prone position. The original technique was recently improved with the introduction of a unique installation in modified supine position. This is a significant simplification of the technique resulting in shorter operative time. Patient’s safety is increased form the anaesthetic point of view. In addition this approach offers the possibility to simultaneously access the urinary tract anterogradely and retrogradely. This allows a more time efficient teamwork and a synergistic combination of different instruments. However, the learning curve of PNL is steep and presently no textbook is available for the urologic community worldwide to learn the technique.

Content Level » Research
Keywords » Endoscopic combined intra-renal surgery - Percutaneous nephrolithotomy - Ureteroscopy - Urolithiasis
Related subjects » Anesthesiology - Medicine - Nephrology - Radiology - Urology

TABLE OF CONTENTS

• Introduction.
• History of PNL.
• Prone PNL: Review and results.
• PNL Indications and guidelines.
• Anatomy for PNL.
• Radiology for stone disease.
• Anesthesiological considerations (especially position related issues) before, during, after.
• Supine PNL.
• Endoscopic Combined Intrarenal surgery.
• Technical aspects of percutaneous management of ureteral stenoses and upper urinary tract transitional cell carcinoma.
• Complications: how to manage them?.
• PNL in pediatric patient.
• Results: published series.
• Conclusions.