Percutaneous Renal Surgery : A Practical Clinical Handbook.

Intro -- Preface -- References -- Suggested further reading -- Contents -- About the Author -- Chapter 1: Applied Anatomy for Percutaneous Access -- Anatomy -- Renal -- Good Track -- Bad Track -- The Body Wall -- Lumbodorsal Fascia -- Horseshoe Kidney -- Anatomy of the Horseshoe Kidney -- Chapter 2: Personnel and Equipment -- Medical Personnel -- Equipment Requirements -- Operation Table -- Patient Positioning -- Imaging -- C-ARM -- Access -- Hydrophilic or "Slippery" Guide Wires -- Artery Forceps -- Retrograde Catheter -- Urethral Catheter -- 16 Fr Foley -- Fixation of the Ureteric Catheter Prior to Placing the Patient Prone -- Contrast -- Patient Drape -- Bairhugger: Blankets and Drapes -- Antibiotics -- DVT: Prophylaxis -- Scalpel -- Guide Wires -- Guide Wires-Types -- Nephrostomy Track Dilators -- Characteristics of Various Dilators -- Amplatz Serial Exchange Dilators -- Telescopic "Car Aerial" Dilators (Alken) -- Balloon Dilators -- Webb Single-Stage Dilator -- Technique of Insertion -- "Mini Perc" Dilators -- Alternative techniques of SSD -- Amplatz Sheath -- Considerations When Using the Amplatz Sheath System -- Sheath Size Selection -- Avoiding Trauma from the Amplatz Sheath -- Puncture Needle -- Irrigation Fluid -- Nephroscopes -- Instruments for Intracorporal Stone Fragmentation -- Pneumatic Ballistic Lithotrites (Lithoclast) -- Sonotrode -- Equipment for Percutaneous Endoscopic Pyloplasty (or Endopyelotomy) -- Stone Grasping Instruments -- Graspers -- Alligator Forceps -- Triradiate Forceps -- Nephrostomies -- Cope Nephrostomy -- Foley Balloon Catheters -- Other Drain Tubes -- Tubeless Nephrostomy -- Chest Drains -- Chapter 3: Indications for PCNL -- Introduction -- Options for the Treatment of Renal Calculi -- Indications for PCNL -- Current Indications for PCNL -- Contraindications to PCNL -- Schematic Comparison of ESWL and PCNL.

ESWL -- Preoperative Investigations Prior to PCNL -- Summary: Preoperative Investigations for PCNL -- Consent -- Preoperative Theatre Preparation -- Large Staghorn Calculus -- Endoscopic Pyeloplasty -- Calyceal Diverticulum -- Obese Patient, Horseshoe Kidney -- Large Impacted Upper Ureteric Calculus -- Chapter 4: Percutaneous Nephrostomy -- Percutaneous Nephrostomy (PCN) -- Surgical Nephrostomy (SN) -- Skinny Needle Surgical Nephrostomy (SNSN) -- Radiological Nephrostomy (RN) -- Surgical Nephrostomy -- Puncture Technique -- Parallax -- Step 1 -- Technique of Percutaneous Renal Puncture -- Lithotomy Position -- Step 2 -- Prone Position of the Patient -- Patient Safety -- Theatre Set-Up -- Radiological Nephrostomy -- Definition -- Chapter 5: Routine PCNL -- Track Dilatation -- Track Size -- Track Dilatation -- Aim -- Principles -- Kinked Guide Wire -- The Body Wall Component of the Nephrostomy Track -- The Skin -- Lumbodorsal Fascia -- Track Dilation -- Guide Wire -- Dilator -- Commencement of the Track and Kidney Dilation -- Nephroscopy and Stone Removal -- Plan -- Nephroscopes -- Blood Clots -- Clot Removal -- Universal Guide Wire -- The Creation of a Universal Guide Wire -- Advantages of a Universal Guide Wire -- Stone Fragmentation -- Alternative Energy Sources for Stone Fragmentation -- Optimal Lithotrites for Stone Fragmentations -- Aims of Stone Fragmentation -- The Sonotrode -- Choice of Lithotrite -- Ultrasonic Lithotrite (Sonotrode) -- Pneaumatic Lithoclast -- Summary -- Stone Extraction for PCNL -- Instruments -- Alligator Forceps -- Triradiate Forceps -- Baskets -- Summary -- Stone Clearance -- Assessment of Stone Clearance at PCNL -- Nephrostomy Post PCNL -- Nephrostomy Types -- "Cope" Loop Nephrostomy -- Foley Catheter -- Tube Nephrostomy (Splinted) -- Tubeless Nephrostomy -- Technique of "Cope" Nephrostomy Insertion Following PCNL.

Alternative Method of Insertion of the "Cope" Loop Nephrostomy -- Lost Nephrostomy -- Suturing the "Cope" Nephrostomy Tube to the Skin -- Technique of Cope Nephrostomy Suture -- Post-operative Care of the Nephrostomy -- Nephrostogram -- Chapter 6: Complex PCNL and Antegrade Endopyelotomy -- Complex Calculi -- Complex Anatomy -- Introduction -- Advanced Skills Required for Difficult PCNL -- Scenario One: Large Infection-related Staghorn Calculus -- Aim -- Potential Problems -- Preoperative Tests, Treatment and Precautions -- CT-IVP -- Pyonephrosis -- Difficulties Encountered with Punctures for Complete Staghorn Calculi -- Technique of Creating an Endoscopic Nephrotomy -- Supplementary Target Punctures during Staghorn Calculus Removal -- Scenario Two: Complex Recurrent Infection Calculi Associated with a Chronically Infected Urinary Diversion or Associated Neurogenic Bladder -- Indications for Stone Removal -- Aims of Treatment -- Pre-admission -- Preoperative Preparation -- Other Preparation -- Theatre: Additional Equipment -- Aims of Surgery -- Ileal Conduit -- Surgical Approach -- Scenario Three: Calculi Within Calyceal Diverticulae -- Anticipated Difficulties -- Aims of the Puncture for Treatment of Stones in a Calyceal Diverticulum -- Preparation Prior to Surgery for Calculi in Calyceal Diverticulae -- CT-IVU: Points to Observe -- Potential Scenarios After Needle Puncture of a Calyceal Diverticulum -- Options -- "Y" Puncture Technique -- Application of the "Y" Puncture for Access into a Calyceal Diverticulum -- If the Guide Wire Will Not Enter the Diverticulum and There Is No Adjacent Calyx -- Stone Removal from a Calyceal Diverticulum -- Drainage -- Scenario Four: The Management of Calculi in a Narrow or Poorly Draining Calyx, or a Stone Forming a Complete Cast of a Calyx -- Scenario Five -- Previous Renal Surgery -- Renal Scarring.

Summary of the Management of Patient Undergoing PCNL in the Presence of Significant Renal and Perirenal Scarring -- Scenario Six -- Obese Patients -- Preoperative Planning -- CT/IVU -- Nephroscope -- Sheath -- Scenario Seven -- Horseshoe Kidney -- Preoperative Planning -- CT-IVU -- Puncture -- Track -- Endoscopy -- Operative Plan -- Scenario Eight -- Large-Impacted Pelviureteric Junction and/or Upper Ureteric Calculus -- Large Upper Ureteric Calculus -- Plan for Antegrade PCNL to Remove a Large Upper Ureteric Calculus -- Preoperative Planning -- CT-IVP -- Procedure -- The "Three-Wire" Antegrade Ureteroscopy Technique -- Amplatz Trauma -- Scenario Nine -- Percutaneous Puncture of a Large Hydronephrosis -- Plan -- Operative Technique -- Scenario Ten: Percutaneous Endopyelotomy (Pyeloplasty) -- Indications -- Surgical Points of Technique and Difficulties with Percutaneous Endopylotomy -- Access -- Operative Plan -- Previous Surgery -- CT-IVP -- Equipment -- Percutaneous Puncture -- Air Contrast Technique -- Percutaneous Endopyelotomy: Operative Technique -- Supracostal Punctures -- Precautions -- Bleeding from Intercostal Vessel -- Pneumothorax -- Chapter 7: Complications of PCNL -- Introduction -- Anatomical Factors Related to PCNL Complications -- The Kidney -- Blood Supply -- Collecting System -- Access to the Kidney Is Blind -- Intrarenal Anatomy -- Summary -- Complications Related to the Nephrostomy Puncture -- Guide Wire Kinking During Dilation -- Damage to Neighbouring Organs -- Bowel -- Needle Puncture of the Bowel -- Dilator Trauma to the Bowel -- During Track Dilation -- Recognition of Perforation at the End of the PCNL -- Renal Vein or IVC Puncture -- Complications During Track Dilation -- Lost Track During Dilation -- If You Are Unable to Successfully Puncture a Selected Calyx -- Amplatz Trauma -- Sites of Amplatz Sheath Trauma.

Lost Amplatz Sheath -- Forceps Trauma -- Triradiate Forceps -- Prevention of Triradiate Forceps Trauma -- Renal Pelvis Perforation -- Management of a Large Pelvic or Infundibular Tear -- Management of Complete PUJ Avulsion -- Infundibular Tears -- Sonotrode Trauma -- "Lost" Calculi -- Lost Nephrostomy Track -- Urinary Tract Infection and Septicaemia -- Management -- Pneumothorax -- Bleeding -- Residual Calculi -- DVT -- Appendix I: Critical Pathways, Theatre Equipment Lists and Setups -- Equipment and Set-Up for PCNL (Nurses Set Up Notes for A/Prof D. Webb Theatre) -- Cystoscopy Trolley -- General Trolley (Top) -- Drains and Dressings -- For Endoscopic Pyeloplasty/Endopyelotomy -- Positioning for Patients with Skeletal Deformities and Spinal Cord Injury -- Nurse Information for PCNL -- Information Sheet -- Stage 1: Cystoscopy -- Stage 2: Kidney Puncture and Removal of Stone -- Post-operative Patient Instructions -- Going Home After Your PCNL -- Comfort and Pain -- Dressing -- Medications -- Activity -- Hygiene -- Nutrition -- Returning to Work and Driving -- Consent Form -- Risks -- Normal Results -- Appendix II: PCNL Workshop -- Workstations -- Participants -- Materials Required for This Workshop -- Equipment for Workshop 5 -- Stations -- Station 1: The Surgical Anatomy of the Kidney and Collecting System Related to Percutaneous Renal Surgery (PCRS) -- Equipment Required -- Aims -- Observations -- Kidney -- Tasks -- Station 2: The Surgical Anatomy of the Kidney and Collecting System Relating to the Establishment of a PCRS Track -- Equipment Required -- Aims -- Observations -- Guide Wires -- "J"-Wires -- Needles -- Dilators -- Amplatz Dilators -- Balloon Dilators -- Car Aerial -- Single-Stage Dilator (Webb) -- Amplatz Sheath -- Tasks -- Guide Wires -- PCN Puncture Needles -- Dilator Systems -- Balloon Dilatation -- Single-Stage Dilator -- Car Aerial.

Nephrostomy.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.