What’s new in percutaneous nephrolithotomy

Abstract

Introduction: The goal of percutaneous nephrolithotomy (PCNL) is to ensure complete stone clearance with minimal morbidity. The key to complete clearance is accurate technique, expertise and instrumentation.

Methods: We systematically reviewed available reports that were identified using a PubMed/Medline search. The keywords used were ‘PCNL’ and ‘advances in PCNL’. The findings were reviewed under the topics of newer developments in imaging, techniques and a review of outcomes with an emphasis on stone clearance and complications.

Conclusion: The newer developments in imaging methods, such as cone-beam computed tomography and staghorn morphometry, help the surgeon to plan the procedure for a safe and better outcome. The highlight of these newer developments is the miniaturisation of instruments. This has translated into developing newer techniques such as the ‘microperc’ and ‘miniperc’. The data-collection initiative by the Clinical Research Office of the Endourological Society has helped in obtaining a high level of evidence.

Keywords:

• Advances
• PCNL
• Microperc
• Miniperc
• Outcome
• Kidney stones

Abbreviations:

• CBCT
• cone-beam CT
• CROES
• Clinical Research Office of the Endourological Society
• PCNL
• percutaneous nephrolithotomy
• HU
• Hounsfield unit
• RIRS
• retrograde intrarenal surgery

Notes

Peer review under responsibility of Arab Association of Urology.