Miniaturization of percutaneous nephrolithotomy Smaller, but better?. Issue 2 (March 2017)

• Record Type: Journal Article
• Authors: Huusmann, Stephan; Nagele, Udo; Herrmann, Thomas R.W.
• Is Part Of: Current opinion in urology. Volume 27:Issue 2(2017:Mar.)
• Page Start: 161
• Page End: 169
• Publication Date: 2017-03
• Subjects: microperc -- miniperc -- MIP -- nephrolithotomy -- ultraminiperc; Urology -- Periodicals; Review Literature -- Bibliography; Review Literature -- Periodicals; Male Urogenital Diseases -- Bibliography; Male Urogenital Diseases -- Periodicals; Female Urogenital Diseases -- Bibliography; Female Urogenital Diseases -- Periodicals; Urologic Diseases -- Bibliography; Urologic Diseases -- Periodicals; Periodicals; 616.6005
• DOI: 10.1097/MOU.0000000000000375
• Languages: English
• ISSNs: 1473-6586

Abstract

Abstract : Purpose of review: Miniaturized percutaneous nephrolithotomy (PCNL) procedures have reached big popularity in the past years. Following the idea that decreasing the diameter of the instruments would decrease the complication rate instruments with outer diameter down to 4, 8 Fr was established. In this review, we want to take a critical insight of the most popular miniaturized procedures, regarding the key advantages and disadvantages of the miniaturized instruments. Recent findings: For all techniques displayed, a number of studies are available to support their effectivity in the given range of indication. Naturally, the body of evidence for M-sized instruments is largest, as it exists in the armamentarium since long, whereas studies comparing small or extrasmall and extraextrasmall to standard or among each other are rare. However, large studies comparing miniaturized procedures with conventional PCNL in randomized controlled fashion are still lacking, too. Summary: Miniaturization and attending developments such as ultrasonographic-guided puncture, single step dilatation of the tract, low irrigation pressure in open systems and a tubeless procedure lead to lower complication rates in PCNL. All of the established procedures have their own range of indication with regard to size and location of the stone. They amplified the possibility of a customized therapy for each patient.