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Description keyboard_arrow_down
Endoscopic intrarenal surgery to extract kidney stones.

Case Record:

  • 78 y.o. male Patient
  • First stone case
  • asymptomatic

Clinical History:

  • Left Kidney Stones: upper calyx 12x9x7mm, 600HU
  • Left Kidney Stone: lower calyx 15x14x6mm, 650 HU
  • Prostatectomy for Prostate cancer 2002

Technique Description:

  • ECIRS (Combined intrarenal surgery)
  • The Patient is positioned in a modified supine Valdivia Galdakau position. 2 surgeons will treat the patient simultaneously
  • It is a combination of retrograde flexible ureteroscopy (RIRS) and mini PNL

Steps in the procedure:

  • Patient Positioning in supine Valdivia Galdakau Position
  • Cystoscopy and retrograde pyelography
  • RIRS
  • Ultrasound guided puncture of the lower calyx –endoscopic controlled
  • One step dilation to the 17.5 Charr Sheet
  • Mini PNL using Storz M 12 Charr
  • Stone disintegration using Trilogy (EMS)
  • Simultaneous RIRS to capture the stones in the upper calyx
  • Removal of the PNL Sheet
  • Removal of the flexible ureterenoscope and placement of a stent in the ureter

Learning points:

  • Patient positioning
  • Endoscopic controlled renal puncture
  • Trilogy settings