By David R Webb
This is the 1st textbook committed totally to percutaneous renal surgical procedure. The textual content explains the fundamental anatomy, tools, music dilation and construction, kidney entry and surgery of all complicated stone eventualities. The ebook is written in basic sections and is greatly illustrated with greater than 250 illustrations. All diagrams were drawn by means of the writer and reproduced via a certified photo artist. The publication describes the fundamental strategies, then progresses clinically via to tougher medical and surgical eventualities. during this manner, it truly is similar to a “cook e-book” well-liked, that's simply referenced and readable. As percutaneous renal surgical procedure is a crew attempt, the ebook includes descriptors for ward and theatre technicians and nurses, in addition to apparatus lists. The booklet additionally features a “do it your self” six-stage percutaneous renal surgical procedure workshop software. This workshop will be played in any division working towards PCNL. Percutaneous Renal surgical procedure: a pragmatic scientific guide represents a realistic handbook, compatible for scientific scholars, nurses and technicians and is a distinct handbook for all urology trainees and urologists treating renal stone sickness worldwide.
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Extra info for Percutaneous Renal Surgery: A Practical Clinical Handbook
Atraumatic to tissues. • Small stone fragments that are difficult to grasp can be aspirated. Disadvantages • Set up is complicated and requires an experienced technician (particularly the suction pump and tubing). • Does not break hard calculi well. • Continuous aspiration can collapse the collecting system of the kidney, limiting vision and irrigation. • Probes overheat very quickly if irrigation ceases, which may cause thermal damage to the patient, surgeon, and burn out the piezoelectric generator.
2. Collecting system As the kidney has not fully rotated, the upper and outer calyces are malrotated and the medial calyces are often distorted. The medial calyces are particularly difficult to access from the renal pelvis with a rigid endoscope due to a combination of angulation and distance. Hence, when treating a horseshoe kidney one should include a flexible cystoscope and laser in the set-up. They are unfortunately the calyces often containing calculi as they are lower most. 3. Pelvis and pelviureteric junction These are anterior and run up and over the isthmus, which may result in compromised drainage.
When used in the ureter, the probe can retropulse and displace stones proximally along the lumen. • Stones require immobilisation for the probe to be effective. This may be difficult in a large renal pelvis. • Prolonged use of the lithoclast in a confined space may cause bleeding. g. struvite stones. • Aspirates particles, so very useful in confined spaces such as the ureter, calyceal diverticula, or stones impacted within calyces. The sonotrode can remove large Guide Wires 39 Fig. 15 Hollow-probe ultrasound lithotrite with generator box and suction pump volumes of stone without needing to remove and re-insert the nephroscope, avoiding track loss and bleeding.