PCNL challenges

Eduardo Cruz-Nuricumbo MD Professor endourology

[PCNL challenges @PCNL_challenges]

@moeltemamy Excellent surgery!! How do you do the following , (time to set the Jj, time to pyelogram after take off JJ) thanks ) and how do you treat if reestenosis appear ?

[PCNL challenges @PCNL_challenges]

PCNL still alive !!, best option for complex staghorn and matrix stones . Right kidney
in this case four access, two mini and two standard, total time surgery 6 hours in two events .

[PCNL challenges @PCNL_challenges]

@sopitas Nosa bia donde estaba la paleta pero luego la encontré la vi y ya mela quería comer

[PCNL challenges @PCNL_challenges]

@EmaMarPa @Endo_Society @JEndourology @YAUEndourology @endouroacademy @CIEndourology @SauUrologia @so_uro One shot amplatz, even in Guy 3 or 4 or, if the Calix is completely occupied by stone, there is not difference between Alken, Amplatz or Ballon. Only exceptions in fibrosis try to use sequential amplatz and in hypermobility try to use Ballon.

[PCNL challenges @PCNL_challenges]

@EmaMarPa @JEndourology @Endo_Society @ResidentesCAU @YAUEndourology When there is resistance the first is the skin, the second is the aponeurosis, there should not be extreme resistance unless there is excessive fibrosis, if there is no fasciotome, the aponeurosis must be opened with a scalpel even under fluoroscopy.

[PCNL challenges @PCNL_challenges]

@REDPINE_Medical @KevinWymer @EndoLuminalEndo @wissamabokhalid @EdgarLindenMD @lucajavier @drjanakddesai @PCNLConvention Tubless when time’s surgery is short (less 90 min.), no injury to epithelium, no plan of second look , no in diverticulum and, when the urine punction is not present.

[PCNL challenges @PCNL_challenges]

@EmaMarPa @ESRUrology @ResidentesAEU @PETRAurogroup @so_uro @Endo_Society @YAUEndourology @BAUSendourology Excellent punction too, although the infundibulum is wide, it is very important to perform transpapillary approach to avoid accidents.

[PCNL challenges @PCNL_challenges]

@EmaMarPa @ESRUrology @ResidentesAEU @PETRAurogroup @so_uro @Endo_Society @YAUEndourology @BAUSendourology Excellent job , a perfect case for supine position !!!

[PCNL challenges @PCNL_challenges]

Choosing the best calix and the best position!! Some times the calix is parallel to spin and is inaccesible to Valdivia position. If you don’t have flexible instruments you have to do more than two tracts.

[PCNL challenges @PCNL_challenges]

@Dosbave Claro sería un honor !!

[PCNL challenges @PCNL_challenges]

Sclerotherapy of renal cyst by percutaneous approach: 1 pyelography, 2 ultrasonography, 3 puncture and confirm with contrast, 4 drainage, 5 alcohol sclerotherapy 20% of the liquid obtained, leave 1 hour closing and go for 24 hrs later to reintroduce alcohol 20% again of liquid.

[PCNL challenges @PCNL_challenges]

@DrPNMaheshwari Indication for sclerotherapy in this patient was pain. Size for better punction above 5 cm, minimal risk of bleeding more common infection , one session in majority of cases is enough but , is important ultrasonography confirmation.

[PCNL challenges @PCNL_challenges]

@uro_corona @saadwael738gma1 I ‘ll try to do a infundibulothomy by percutaneous acces upper pole, and set a foley #18 in pelvis but just one time , if development another recurrence avoid the case !!!

[PCNL challenges @PCNL_challenges]

Infundibular stenosis caused by fibrosis of upper calyx, open by laser under renoscopy, tips: use low energy , high frequency, start opening in areas with scar, pale or mimic Randall plaque lesions, pass a guide. Leave catheter jj for one month and wait for re-epithelialization.

[PCNL challenges @PCNL_challenges]

@VicentiniUro @Endo_Society @endourologyccf @BEkidneystone @urobraulio @GuidoGiusti @Urologeman @ytanidir @2fabiosepulveda Agree it looks matrix stone!!

[Karen Mendoza Bravo @karenmbravo]

@DrUbaidUrRahma1 @UroHRAEPY

[Karen Mendoza Bravo @karenmbravo]

Inicia la preselección y convocatoria para Fellowship en endourologia ☄️💥⚡️@UroHRAEPY
https://t.co/tbOxcNN7KW

[PCNL challenges @PCNL_challenges]

Fellowship endourology

[Karen Mendoza Bravo @karenmbravo]

52YO 🚺 Bilateral lithiasis, BMI 36 PCNL double tract ☄️ one of them (inferior calix) usg guided and without nephrostomy... a second look will be needed 🤯. @UroHRAEPY @juanjoselascano @PCNL_challenges (not available simple TC) #UroSoMe

[PCNL challenges @PCNL_challenges]

@2fabiosepulveda @Urologeman I think would be better take renal gammagram before to take action, if is really convenient save the kidney or not. The parenchyma looks very thin, less 7 cm.