Minimal-Invasive PCNL (Mini-PCNL)
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Forty years ago conventional PCNL was introduced as a very effective stone treatment modality, which shows excellent stonefree rates. But conventional PCNL is associated with significant complications, such as a high transfusion rate of 10%. In order to minimize the complication rate of a conventional PCNL but to preserve the excellent stonefree, rate the minimally invasive percutaneous nephrolithotomy (Mini-PCNL) in adults was established in 2001. Mini-PCNL is done by means of a miniaturized nephroscope up to 12 F and a small caliber Amplatz sheath (up to 18 F). Although the underlying principle of the Mini-PCNL is similar to the conventional PCNL, there are some significant differences. Stone removal in Mini-PCNL is achieved without any forceps or baskets. Due to the particular relation of the length and diameter of the Amplatz sheath in Mini-PCNL, the so-called vacuum-cleaner takes all stone fragments automatically out of the calyceal system. Mini-PCNL can be applied in almost all stone patients with stones of the upper urinary tract exceeding 2 cm. Even staghorn stones can be successfully treated by a multi-tract Mini-PCNL approach. Recently various modifications of Mini-PCNL were presented, such as Micro-PCNL, Ultra-Mini-PCNL, Perfect Perc and Super-Mini-PCNL. It can be said today that Mini-PCNL is an indispensable treatment modality in endourological stone treatment.
KeywordsPercutaneous nephrolithotomy Urolithiasis Holmium laser Minimal-invasive surgery
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