Reyes ZFJ, Escovar DPA, Porras MMG

Language: Spanish
References: 10
Page: 258-263
PDF size: 87.38 Kb.

ABSTRACT

In the last two decades, the treatment of the calculus has changed extraordinarily, the present tendency are the minimally bloody procedures that guarantee the solution of the stone load. Percutaneous renal surgery is due to make in exact and meticulous form with the purpose of diminishing the complications associated to vascular injury or neighboring organs. Objective. To describe the form to surely make a percutaneous access to the kidney, crossing of papilla renal, using bi-dimensional data obtained by fluoroscopy. Material and methods. We used the set of telescopic dilators, nephroscope with external sheath 24 Fr. and vision to 15°. Under general anesthesia previously guide in the affected side introduces itself and later in prone position is placed a sub costal wedge and in iliac crest to reject the colon in previous form. For the execution of the percutaneous boarding, selections the calyx that allow us to extract the stone load and of the posterior group. To manage to locate the direction and depth of the calyx, the selections by means of projections anterior-posterior and totally lateral and this way obtains the point in the skin where puncture must be made, which guarantees to us to follow the same direction and depth of the calyx and to arrive the center from papilla. Results. By means of this technical we have made 18 percutaneous boarding’s of November of 2003 to October of 2004. Ten cases with renal pelvis stone, eight cases with choral stone that they have required second tract and two of which with residual stones submissive extracorporeal shock-wave litotripsy, 0% of complications. Discussion. The percutaneous renal surgery has very clear indications and must offer excellent results with morbidity minimal. The presented technique, own of the Dr. Paul Escovar, guarantees security and effectiveness to us when adapting the bi-dimensional information to a three-dimensional organ and to manage puncture to trans-papillary of a posterior calyx, following its same direction.

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