Once an adequate percutaneous tract is created, the next step is to clear the stone. The fragmentation and extraction strategies should be tailored according to stone (hardness, location, size, and burden) and instrument (chosen size of the Amplatz sheath, diameter of the working channel of the endoscope in use) factors. Such strategies are similar in both prone and supine position, in spite of the fact that the slightly downward inclination of the Amplatz sheath in the supine position favors fragments’ spontaneous evacuation. Various tips and tricks, like the variety of laser settings with their different effects or the vacuum-cleaner effect, are described.
Calcium Oxalate Stone Fragment Calcium Oxalate Monohydrate Calcium Oxalate Dihydrate Staghorn Stone
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.
This is a preview of subscription content, log in to check access.
Hemal AK, Goel A, Aron M et al (2003) Evaluation of fragmentation with single or multiple pulse setting of Lithoclast for renal calculi during percutaneous nephrolithotripsy and its impact on clearance. Urol Int 70:265–268PubMedCrossRefGoogle Scholar
Nerli RB, Koura AC, Prabha V et al (2008) Use of LMA Stonebreaker as an intracorporeal lithotrite in the management of ureteral calculi. J Endourol 22:641–644PubMedCrossRefGoogle Scholar
Chew BH, Arsovska O, Lange D et al (2011) The Canadian StoneBreaker trial: a randomized, multicenter trial comparing the LMA StoneBreaker and the Swiss LithoClast(R) during percutaneous nephrolithotripsy. J Endourol 25:1415–1419PubMedCrossRefGoogle Scholar
Alken P (2010) PNL for staghorn stones. In: Rane AM, Desai M, Keeley FX (eds) Top tips in endourology. Euromed Communications, Passfield, pp 20–24Google Scholar
Clayman RV (2000) Nephroscopy sheath characteristics and intrarenal pressure: human kidney model. J Urol 163:1616PubMedGoogle Scholar
Lahme S, Bichler KH, Strohmaier WL, Gotz T (2001) Minimally invasive PCNL in patients with renal pelvic and calyceal stones. Eur Urol 40:619–624PubMedCrossRefGoogle Scholar
Lahme S, Zimmermanns V, Hochmuth A, Janitzki V (2008) Minimally invasive PCNL (mini-perc). Alternative treatment modality or replacement of conventional PCNL? Urologe A 47:563–568PubMedCrossRefGoogle Scholar
Nagele U, Schilling D, Sievert KD (2008) Management of lower-pole stones of 0.8 to 1.5 cm maximal diameter by the minimally invasive percutaneous approach. J Endourol 22:1851–1853, discussion 7PubMedCrossRefGoogle Scholar
Hoffman N, Lukasewycz SJ, Canales B et al (2004) Percutaneous renal stone extraction: in vitro study of retrieval devices. J Urol 172:559–561PubMedCrossRefGoogle Scholar