The most frequently arising complication during percutaneous surgery is perforation of the renal pelvis. This occurs more often during puncture and dilatation of the track and seldom during the operation itself. As long as drainage of the renal cavity system is satisfactory, there is no need to resort to open surgery (Fig. 55). After the injection of contrast, the X-ray shows extensive extravasations, some of which run a pararenal course, but most of which run paraureterally down the psoas muscle. When the puncture needle and later on the dilatation rod are securely positioned in the renal cavity system, the dilatation procedure can be terminated. If perforations occur during the actual operation, the pressure of the irrigant should be reduced as much as possible to avoid water influx similar to a transurethral resection syndrome. The operation should be interrupted and a nephrostomy catheter inserted. The wound usually heals in 2 to 3 days, at which time the operation can be continued.
KeywordsKidney Stone Renal Pelvis Psoas Muscle Puncture Needle Urinary Fistula
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