Puncture of the Kidney

Abstract

The art of laying a good percutaneous track is probably the most important prerequisite for the success of a percutaneous kidney stone operation. A mislaid track can make it necessary to interrupt the operation to find a better track. A stone in the upper part of the ureter, for example, could hardly be reached if the track led into the kidney via the lower pole. Directing the instrument into the upper ureter requires keeping the angle as flat as possible. Even the flexible fiberscope is of no help here, since experience has shown that calculi in the upper ureter are difficult to move and stronger instruments are needed to get them out. It can also be a problem to remove a calyceal stone in a middle calyx group if a neighboring calyx which covers over the stone and possibly over the entire calyx is erroneously selected for puncture.