StoneSmart

Welcome to the StoneSmart™ case video series where you can learn from your peers who have shared their insights, approaches and techniques to challenging stone procedures and complex patient presentations.

This series will continue to expand with new insights and content intended to further the conversation around evolving challenges you face in your urology department or practice and the ways endourology innovations can advance procedural techniques and operational efficiencies.

Ultrasound-guided Renal Access for PCNL: Severe Spinal Deformity

Ultrasound-guided access is the primary technique for PCNL in China and has been for over a decade. Dr. Li, who has conducted over 20,000 x-ray free PCNLs with his team since 2004, shares the case of a middle-aged male with bilateral staghorn stones and severe spinal deformity. Dr. Li explains how ultrasound-guided PCNL access helped to mitigate potential injury for this particular case.

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Ultrasound-guided Renal Access for PCNL – Clinical Considerations: Part I

Dr. Chi describes the key skills required to utilizing ultrasound-guided renal access for PCNL. He discusses the key elements to optimizing renal imaging and orienting yourself to anatomical landmarks, as well as needle control, including placement and puncture. Dr. Chi provides clinical considerations to improving imaging and needle skills, and a method for overcoming the learning curve to utilizing ultrasound.

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Ultrasound-guided Renal Access for PCNL – Clinical Considerations: Part II

Dr. Chi discusses the use of ultrasound-guided renal access for PCNL in two different case presentations – one patient in prone and another in supine position. For each patient position, Dr. Chi describes identification of important anatomical landmarks for image orientation and his technique for calyx targeting and stone identification. Dr. Chi closes with his method for utilizing ultrasound guided renal tract dilation.

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