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World Journal of Urology

, Volume 28, Issue 2, pp 239–244 | Cite as

X-ray-free percutaneous nephrolithotomy in supine position with ultrasound guidance

  • Abbas BasiriEmail author
  • Mehrdad Mohammadi Sichani
  • Seyed Reza Hosseini
  • Aliakbar Moradi Vadjargah
  • Nasser Shakhssalim
  • Amir Hossein Kashi
  • Mohammadreza Kamranmanesh
  • Hamidreza Nasseh
Original Article

Abstract

Purpose

Supine percutaneous nephrolithotomy (PCNL) has numerous benefits compared to the prone position, including lower anesthesia risk, shorter operating time, and better ergonomic position for the surgeon. It is also comparable to prone position regarding vascular and bowel injuries. This study was conducted to add some more benefits by omitting X-ray in PCNL in a supine position.

Methods

Nineteen consecutive adult patients underwent ultrasound-guided PCNL in supine position. All patients were placed under ultrasound guidance in supine position. The tract was dilated over a guidewire in a single shot technique under ultrasound guidance from anterior abdominal wall. Once the procedure ended, residual stone was controlled using ultrasound with anterior abdominal wall window. Residual stones less than 5 mm were considered insignificant. No X-ray was used in any setting of the procedure.

Results

The pelvicaliceal system could be successfully approached in all patients. The posterior calices were the most common sites of entry. Mean (range) of operation time was 111 (70–180) min. Mean ± SD hemoglobin before PCNL was 14.0 ± 2.2 mg/dl, and after the procedure it was 12.3 ± 1.6 mg/dl. Only one patient required blood transfusion. Mean ± SD creatinine before PCNL was 1.03 ± 0.24 mg/dl, and after the procedure it was 1.11 ± 0.22 mg/dl. None of the patients suffered visceral injury. The total stone-free rate was 84%.

Conclusions

Even in our first report with limited experience, it seems that the efficacy of PCNL with ultrasonography in supine position is comparable to PCNL in prone position with fluoroscopy with no more complications.

Keywords

Percutaneous nephrolithotomy Supine Ultrasound 

Notes

Conflict of interest statement

There is no conflict of interest.

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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Abbas Basiri
    • 1
    Email author
  • Mehrdad Mohammadi Sichani
    • 1
  • Seyed Reza Hosseini
    • 1
  • Aliakbar Moradi Vadjargah
    • 1
  • Nasser Shakhssalim
    • 1
  • Amir Hossein Kashi
    • 1
  • Mohammadreza Kamranmanesh
    • 2
  • Hamidreza Nasseh
    • 1
  1. 1.Department of UrologyUrology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University, M.C. (SBMU)TehranIran
  2. 2.Department of AnesthesiologyUrology and Nephrology Research Center (UNRC), Shahid Labbafinejad Medical Center, Shahid Beheshti University, M.C. (SBMU)TehranIran

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