ECIRS: Access Creation

  • Cesare Marco Scoffone
  • András Hoznek
  • Cecilia Maria Cracco
Chapter
First Online:

Abstract

A suitable percutaneous access is the key point of the success of any PNL, maximizing the effectiveness of the procedure in terms of stone-free status and minimizing the risk of complications. The selection of the best calyx of entry should be preoperatively planned, to define the better strategy for a definite patient with a given urolithiasis. The first operative step of ECIRS (preliminary flexible ureteroscopy) has a fundamental diagnostic importance for defining stone and collecting system features impossible to define by means of any preoperative investigation. Renal puncture and tract dilation modalities are discussed. Fluoroscopy and ultrasound guidance, and Endovision control of the supine renal puncture are described and other guidance methods considered (retrograde nephrostomy application, all-seeing needle, image-fusion and iPad guidance, electromagnetic tracking system, navigation systems, and telerobotic arms). Guidewire application and management and tract dilation-related problems are afforded, according to the authors’ expertise.

Keywords

Needle Guide Tract Dilation Flexible Ureteroscopy Staghorn Stone Electromagnetic Tracking System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer-Verlag France 2014

Authors and Affiliations

  • Cesare Marco Scoffone
    • 1
  • András Hoznek
    • 2
  • Cecilia Maria Cracco
    • 1
  1. 1.Department of UrologyCottolengo HospitalTorinoItaly
  2. 2.Department of UrologyCHU Henri MondorCréteil CedexFrance

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