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Percutaneous Access to the Kidney: Endoscopic

  • Adam Kaplan
  • Jaime LandmanEmail author
Chapter

Abstract

Proper access to the renal collecting system presents the greatest challenge for the urologist performing percutaneous nephrolithotomy for large renal stones. This chapter describes a technique for percutaneous renal access in which placement of a ureteral access sheath and ureteroscopy in the prone position provide direct visualization of percutaneous needle placement through the kidney. Nephrolithotomy tract dilation and sheath placement occur in a similar fashion to standard PCNL, but with the advantage of direct visualization. With this technique, precise renal access can be obtained with fewer renal punctures, optimized position of the access into a superior pole posterior calyx, decreased complication rates, and improved stone clearance.

Keywords

Needle Puncture Stone Burden Tract Dilation Access Sheath Flexible Ureteroscope 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of UrologyUniversity of California, Irvine Medical CenterOrangeUSA

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