Abstract
Introduction
The indications for PCNL have seen a paradigm shift in the past decade. In the earlier years, PCNL was done for large-volume stones such as complex multiple calyceal calculi, staghorn stones. The advent of miniaturization of instruments ushered in smaller scopes, smaller retrieval devices, and energy sources. The miniaturization of instruments also was responsible in the paradigm shift in the indications for PCNL. These miniaturized instruments and accessories obviate the need to dilate the tract beyond 20 Fr. Various studies in the past have confirmed that reducing the tract size potentially also reduces the complications of percutaneous surgery.
Materials and Methods
In this article, we discuss the new developments in percutaneous surgery in the past decade with emphasis on techniques of Microperc, Miniperc, and Ultraminiperc.
Conclusion
The newer techniques with Miniperc are suited for stones 1.5–2 cm in size. Microperc and Ultraminiperc may be suitable for stone sizes <1.5 cm. These are also suited for special situations such as diverticular stones and pediatric moderate-sized stones. The indications of these newer techniques compete with those of extracorporeal shockwave lithotripsy and flexible ureteroscopy.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Kukreja R, Desai M, Patel S et al (2004) Factors affecting blood loss during percutaneous nephrolithotomy: prospective study. J Endourol. 18(8):715–722
Jackman SV, Docimo SG, Cadeddu JA, Bishoff JT, Kavoussi LR, Jarrett TW (1998) The “mini-perc” technique: a less invasive alternative to percutaneous nephrolithotomy. World J Urol 16:371–374
Lahme S, Bichler KH, Strohmaier WL, Gotz T (2001) Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 40:619–624
Sabnis RB, Ganesamoni R, Sarpal R (2012) Miniperc: what is its current status? Curr Opin Urol 22:129–133
AkitoYa, Skolarikos A, Buchholz N et al. on behalf of the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Study Group (2011) Operating times and bleeding complications in percutaneous nephrolithotomy: a comparison of tract dilation methods in 5537 patients in the Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy global study. J. Endourol 25(6):933–939
Knoll T, Wezel F, Michel MS (2010) Do patients benefit from miniaturized tubeless percutaneous nephrolithotomy? A comparative prospective study. J Endourol 24(7):1075–1079
Mishra S, Sharma R, Garg C (2011) Prospective comparative study of Miniperc and standard PNL for treatment of 1 to 2 cm size renal stone. BJU Int 108(6):896–899
Bader M, Christian G, Boris S et al (2010) The “All Seeing Needle”—an optical puncture system confirming percutaneous access in PCNL. J Urol 183(4):e734
Desai MR, Sharma R, Mishra S et al (2011) Single-step percutaneous nephrolithotomy (Microperc): the initial clinical report. J Urol 186:140–145
Tepeler A, Armagan A, Sancaktutar AA et al (2013) The role of Microperc in the treatment of symptomatic lower pole renal calculi. J Endourol 27:13–18
Armagan A, Tepeler A, Silay MS et al (2013) Micropercutaneous nephrolithotomy in the treatment of moderate-size renal calculi. J Endourol 27:177–181
Sabnis RB, Ganesamoni R, Doshi A et al (2013) Micropercutaneous nephrolithotomy (Microperc) vs. retrograde intrarenal surgery for the management of small renal calculi: a randomized controlled trial. BJU Int 112(3):355–361
Desai J, Zeng G, Zhao Z, Zhong W, Chen W, Wu W (2013) A novel technique of ultra-mini-percutaneous nephrolithotomy: introduction and an initial experience for treatment of upper urinary calculi less than 2 cm. Biomed Res Int 2013:490793
Conflict of interest
None.
Ethical standard
The data presented by the authors have been approved by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in the Declaration of Helsinki 1964 and its later amendments.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ganpule, A.P., Bhattu, A.S. & Desai, M. PCNL in the twenty-first century: role of Microperc, Miniperc, and Ultraminiperc. World J Urol 33, 235–240 (2015). https://doi.org/10.1007/s00345-014-1415-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00345-014-1415-1