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Endoscopic Combined IntraRenal Surgery (ECIRS): Rationale

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Supine Percutaneous Nephrolithotomy and ECIRS

Abstract

The present chapter reviews the rationale of ECIRS (Endoscopic Combined IntraRenal Surgery), the logical evolution of PNL and of the old prone split-leg position. ECIRS would not exist without the Galdakao-modified supine Valdivia position, specifically supporting this versatile antero-retrograde approach to the upper urinary tract. ECIRS is a synergic approach in all its aspects, being a combination of retrograde intrarenal surgery (RIRS) and antegrade PNL and including essential intraoperative interactions among all operators (urologists, anaesthesiologists, nurses, scrub nurse, radiology technician, with the respective armamentaria), rigid and flexible instruments, endoscopes and accessories, intraoperative imaging techniques for renal puncture, ECIRS itself, and other surgical techniques. The anesthesiological, urological, and management advantages of ECIRS are described in detail.

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References

  1. Türk C, Knoll T, Koehrmann KU (2008) New guidelines for urinary stone treatment. Controversy or development? Urologe A 47:591–593

    Google Scholar 

  2. Guenther R, Alken P, Altwein JE (1978) Percutaneous nephro-pyelostomy applications and results. Rofo 128:720–726

    Article  Google Scholar 

  3. Alken P, Hutschenreiter G, Günter R, Marberger M (1981) Percutaneous stone manipulation. J Urol 125:463–466

    PubMed  CAS  Google Scholar 

  4. Cracco CM, Scoffone CM, Scarpa RM (2011) New developments in percutaneous techniques for simple and complex branched renal stones. Curr Opin Urol 21:154–160

    Article  PubMed  Google Scholar 

  5. Scoffone CM, Cracco CM, Cossu M et al (2008) Endoscopic combined intrarenal surgery in Galdakao-modified supine Valdivia position: a new standard for percutaneous nephrolithotomy? Eur Urol 54:1393–1403

    Article  PubMed  Google Scholar 

  6. Cracco CM, Scoffone CM (2011) ECIRS (Endoscopic Combined IntraRenal Surgery) in the Galdakao-modified supine Valdivia position: a new life for percutaneous surgery? World J Urol 29:821–827

    Article  PubMed  Google Scholar 

  7. Lehman T, Bagley DH (1988) Reverse lithotomy modified prone position for simultaneous nephroscopic and ureteroscopic procedures in women. Urology 32:529–531

    Article  PubMed  CAS  Google Scholar 

  8. Kerbl K, Clayman RV, Chandhoke PS et al (1994) Percutaneous stone removal with the patient in the flank position. J Urol 151:686–688

    PubMed  CAS  Google Scholar 

  9. Gofrit ON, Shapiro A, Donchin A et al (2002) Lateral decubitus position for percutaneous nephrolithotripsy in the morbidly obese or kyphotic patient. J Endourol 16:383–386

    Article  PubMed  Google Scholar 

  10. El-Husseiny T, Moraitis K, Maan Z et al (2009) Percutaneous endourologic procedures in high-risk patients in the lateral decubitus position under regional anesthesia. J Endourol 23:1603–1606

    Article  PubMed  Google Scholar 

  11. Scarpa RM, Cossu FM, De Lisa A et al (1997) Severe recurrent ureteral stricture, the combined use of an anterograde and retrograde approach in the prone-split-leg position without X-rays. Eur Urol 31:254–256

    PubMed  CAS  Google Scholar 

  12. Grasso M, Nord R, Bagley DH (1993) Prone split leg and flank roll positioning: simultaneous anterograde and retrograde access to the upper urinary tract. J Endourol 7:307–310

    Article  PubMed  CAS  Google Scholar 

  13. Karami H, Rezaei A, Mohammadhosseini M et al (2010) Ultrasonography-guided percutaneous nephrolithotomy in the flank position versus fluoroscopy-guided percutaneous nephrolithotomy in the prone position: a comparative study. J Endourol 24:1357–1361

    Article  PubMed  Google Scholar 

  14. Jang WS, Choi KH, Yang SC, Han WK (2011) The learning curve for flank percutaneous nephrolithotomy for kidney calculi: a single surgeon’s experience. Korean J Urol 52:284–288

    Article  PubMed  Google Scholar 

  15. Ray AA, Chung DG, Honey RJ (2009) Percutaneous nephrolithotomy in the prone and prone-flexed positions: anatomic considerations. J Endourol 23:1607–1614

    Article  PubMed  Google Scholar 

  16. Honey RJ, Wiesenthal JD, Ghiculete D et al (2011) Comparison of supracostal versus infracostal percutaneous nephrolithotomy using the novel prone-flexed patient position. J Endourol 25:947–954

    Article  PubMed  Google Scholar 

  17. Lezrek M, Ammani A, Bazine K et al (2011) The split-leg modified lateral position for percutaneous renal surgery and optimal retrograde access to the upper urinary tract. Urology 78:217–220

    Article  PubMed  Google Scholar 

  18. Shoma AM, Eraky I, El-Kenawy MR et al (2002) Percutaneous nephrolithotomy in the supine position: technical aspects and functional outcome compared with the prone technique. Urology 60:388–392

    Article  PubMed  Google Scholar 

  19. Ng MT, Sun WH, Cheng CW, Chan ES (2004) Supine position is safe and effective for percutaneous nephrolithotomy. J Endourol 18:469–474

    Article  PubMed  Google Scholar 

  20. Steele D, Marshall V (2007) Percutaneous nephrolithotomy in the supine position: a neglected approach? J Endourol 21:1433–1437

    Article  PubMed  Google Scholar 

  21. Falahaktar S, Moghaddam AA, Salhei M et al (2008) Complete supine percutaneous nephrolithotripsy comparison with the prone standard position. J Endourol 22:2513–2517

    Article  Google Scholar 

  22. Chedid Neto EA, Mitre AI, Mendes Gomes C et al (2007) Percutaneous nephrolithotripsy with the patient in a modified supine position. J Urol 178:165–168

    Article  Google Scholar 

  23. Valdivia Uria JG, Lanchars E, Villaroya S (1987) Percutaneous nephrolithectomy: simplified technique (preliminary report). Arch Esp Urol 40:177–180

    PubMed  CAS  Google Scholar 

  24. Valdivia Uria JG, Valle GJ, Villaroya S (1990) Why is percutaneous nephroscopy still performed with the patient prone? J Endourol 4:269–272

    Article  Google Scholar 

  25. Valdivia Uria JG, Valle GJ, Lopez Lopez JA et al (1998) Technique and complications of percutaneous nephroscopy: experience with 557 patients in the supine position. J Urol 160:1975–1978

    Article  PubMed  CAS  Google Scholar 

  26. Arrabal-Polo MA, Arrabal-Martin M, Saz T, Paiz P (2011) Emergency percutaneous nephrostomy in supine-oblique position without cushion. Urol Res 39:521–522

    Article  PubMed  Google Scholar 

  27. Xu KW, Huang J, Guo ZH et al (2011) Percutaneous nephrolithotomy in semisupine position: a modified approach for renal calculus. Urol Res 39:467–475

    Article  PubMed  Google Scholar 

  28. Ibarluzea G, Scoffone C, Cracco CM et al (2007) Supine Valdivia and modified lithotomy position for simultaneous anterograde and retrograde urological access. BJU Int 100:233–236

    Article  PubMed  Google Scholar 

  29. Daels F, Gonzalez MS, Freire FG et al (2009) Percutaneous lithotripsy in Valdivia-Galdakao decubitus position: our experience. J Endourol 23:1615–1620

    Article  PubMed  Google Scholar 

  30. Miano R, Scoffone C, De Nunzio C et al (2010) Position: prone or supine is the issue of percutaneous nephrolithotomy. J Endourol 24:931–938

    Article  PubMed  Google Scholar 

  31. Hoznek A, Rode J, Ouzaid I et al (2012) Modified supine percutaneous nephrolithotomy for large kidney and ureteral stones: technique and results. Eur Urol 61:164–170

    Article  PubMed  Google Scholar 

  32. Agah M, Ghasemi M, Roodneshin F et al (2011) Prone position in percutaneous nephrolithotomy and postoperative visual loss. Urol J 8:191–196

    PubMed  Google Scholar 

  33. Akhavan A, Gainsburg DM, Stock JA (2010) Complications associated with patient positioning in urologic surgery. Urology 76:1309–1316

    Article  PubMed  Google Scholar 

  34. Anusionwu IM, Wright EJ (2011) Compartment syndrome after positioning in lithotomy: what a urologist needs to know. BJU Int 108:477–481

    Article  PubMed  Google Scholar 

  35. Edgcombe H, Carter K, Yarrow S (2008) Anaesthesia in the prone position. Br J Anaesth 100:165–183

    Article  PubMed  CAS  Google Scholar 

  36. Ho JD, Dawes DM, Moore JC et al (2011) Effect of position and weight force on inferior vena cava diameter – implications for arrest-related deaths. Forensic Sci Int 212:256–259

    Article  PubMed  Google Scholar 

  37. Rau CS, Liang CL, Lui CC et al (2002) Quadriplegia in a patient who underwent posterior fossa surgery in the prone position. J Neurosurg 96(1 Suppl):101–103

    PubMed  Google Scholar 

  38. Tempelhoff R (2008) An optic nerve at risk and a prolonged surgery in the prone position. Anesthesiology 108:775–776

    Article  PubMed  Google Scholar 

  39. De Sio M, Autorino R, Quarto G et al (2008) Modified supine versus prone position in percutaneous nephrolithotomy for renal stones treatable with a single percutaneous access: a prospective randomized trial. Eur Urol 54:196–203

    Article  PubMed  Google Scholar 

  40. De La Rosette JJ, Tsakiris P, Ferrandino MN et al (2008) Beyond prone position in percutaneous nephrolithotomy: a comprehensive review. Eur Urol 54:1262–1269

    Article  PubMed  Google Scholar 

  41. Liu L, Zheng S, Xu Y, Wei Q (2010) Systematic review and meta-analysis of percutaneous nephrolithotomy for patients in supine versus prone position. J Endourol 24:1941–1946

    Article  PubMed  Google Scholar 

  42. Wu P, Wang L, Wang K (2011) Supine versus prone position in percutaneous nephrolithotomy for kidney calculi: a meta-analysis. Int Urol Nephrol 43:67–77

    Article  PubMed  Google Scholar 

  43. Arrabal-Martin M, Arrabal-Polo MA, Lopez-Leon V et al (2012) The oblique supine decubitus position: technical description and comparison of results with the prone decubitus and dorsal decubitus positions. Urol Res 40:587–592

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Urology, Cottolengo Hospital, Via Cottolengo 9, 10152, Torino, Italy

    Cesare Marco Scoffone MD & Cecilia Maria Cracco MD, PhD

  2. Department of Urology, San Luigi Hospital, University of Torino, Regione Gonzole, 10, 10043, Orbassano, Torino, Italy

    Roberto Mario Scarpa

Authors
  1. Cesare Marco Scoffone MD
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  2. Cecilia Maria Cracco MD, PhD
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  3. Roberto Mario Scarpa
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Corresponding author

Correspondence to Cesare Marco Scoffone MD .

Editor information

Editors and Affiliations

  1. Dept. Of Urology, Cottolengo Hospital, Torino, Italy

    Cesare Marco Scoffone

  2. Service d’Urologie, CHU Henri Mondor, Créteil cedex, France

    András Hoznek

  3. Cottolengo Hospital, Torino, Italy

    Cecilia Maria Cracco

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Scoffone, C.M., Cracco, C.M., Scarpa, R.M. (2014). Endoscopic Combined IntraRenal Surgery (ECIRS): Rationale. In: Scoffone, C., Hoznek, A., Cracco, C. (eds) Supine Percutaneous Nephrolithotomy and ECIRS. Springer, Paris. https://doi.org/10.1007/978-2-8178-0459-0_10

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  • DOI: https://doi.org/10.1007/978-2-8178-0459-0_10

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  • Publisher Name: Springer, Paris

  • Print ISBN: 978-2-8178-0359-3

  • Online ISBN: 978-2-8178-0459-0

  • eBook Packages: MedicineMedicine (R0)

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