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ECIRS using Trilogy (EMS)
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
