scholarly journals Percutaneous Extraction of Big Kidney Stone without Fragmentation: The Novel Technique in Percutaneous Nephrolithotomy (EN BLOCK PCNL)

2021 ◽  
Vol 8 (6) ◽  
Author(s):  
Karami HOR ◽  
◽  
Vahidi SRJ ◽  
Abouei SA ◽  
Gholizadeh HAM ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Gold Standard ◽  
Kidney Stone ◽  
Renal Stone ◽  
Operative Time ◽  
Standard Treatment ◽  
The Novel ◽  
Novel Technique ◽  
Percutaneous Extraction ◽  
First Time

PCNL is gold standard treatment of pelvis stone more than 2 cm. Since 1970 that PCNL was introduced, multiple methods including mini PCNL, Lap assisted PCNL and etc. were used to increase the efficacy and decrease the complications of PCNL in different patients. We describe a new method of PCNL for the first time for extracting 7 cm renal stone without fragmentation and we called it EN BLOCK PCNL. Our technique had no complication and caused lower operative time and hospital stay.

scholarly journals Outcomes of Retrograde Intra-Renal Surgery

2019 ◽  
Vol 2 (2) ◽  
pp. 220-223 ◽  
Author(s):  
Samir Shrestha ◽  
Pukar Maskey
Keyword(s):  
Postoperative Pain ◽  
Hospital Stay ◽  
Renal Stone ◽  
Operative Time ◽  
Renal Calculi ◽  
Renal Surgery ◽  
Surgical Morbidity ◽  
Retrograde Intrarenal Surgery ◽  
Stone Clearance ◽  
The Mean

Introduction: Miniaturization of endoscopic instruments has gained wide popularity in the treatment of renal calculi. Retrograde intra-renal surgery and holmium laser in combination has already proven its superiority when compared to other modalities in the treatment of renal calculi. This study was conducted to assess the outcome of retrograde intra-renal surgery in renal stone disease.Materials and Methods: This retrospective study analyzed the outcome of retrograde intra-renal surgery in renal stone less than 2 cm size in the adults above 18 years of age from September 2018 to August 2019 at Patan Hospital, Nepal. The outcome was assessed descriptively on postoperative pain and fever, stone localization, stone size, stone clearance, urosepsis, operative time, hospital stay, mortality, need of the second procedure.Results: A total of 62 patients underwent retrograde intrarenal surgery, out of which 48 cases were included. The mean age of the study population was 32.4± 14 years (19-68 years). Similarly, the mean operative time was 68± 12 (48-124 minutes) and mean hospital-stay was 3.2± 1.1 days. Postoperative pain and fever were observed in 14 (29.16%) & 4(8.33%) patients respectively. Hematuria occurred in 6(12.50%) and urosepsis in 2(4.16%) of the patients. Complete stone clearance was achieved in 34(70.83%) and residual stones were present in 8(16.66%) and clinically insignificant radiological fragments were present in 6(12.50%) patients.Conclusions: Retrograde intrarenal surgery is a technically safe and effective procedure for the treatment of renal calculi, with minimal post-surgical morbidity.

scholarly journals Comparison of three port laparoscopic cholecystectomy with four port laparoscopic cholecystectomy

2022 ◽  
Vol 21 (1) ◽  
pp. 151-157
Author(s):  
Ram Kirti Garg ◽  
Rajesh Kumar ◽  
Bir Singh ◽  
Rikki Singal ◽  
Kiran Kumar Singal ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gold Standard ◽  
Operative Time ◽  
Standard Treatment ◽  
Medical Science ◽  
Cosmetic Appearance

Objective: Laparoscopic cholecystectomy, gold standard treatment for cholelithiasis, has traditionally been done using 4 ports. We compared four port procedure with newer 3-port cholecystectomy. Methods: Sixty patients were operated by equally dividing them into two groups and using two procedures mentioned in the objective. Results and Discussion: Assessment was carried out using parameters like operative time, cosmetic appearance and complications. Results were similar except operative time which was much less with 4-port procedure. Conclusion: It will require lot of training before three port laparoscopic cholecystectomy can become popular and beneficial compared to four-port procedure. Bangladesh Journal of Medical Science Vol. 21(1) 2022 Page : 151-157

scholarly journals Retrograde Intrarenal Surgery (RIRS) vs Percutaneous Nephrolithotomy (PCNL) in Treatment of Lower Pole Renal Stone

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
S I Ragy ◽  
A A Elshorbagy ◽  
M A Alzqzouq
Keyword(s):  
Hospital Stay ◽  
Renal Stone ◽  
Operative Time ◽  
Randomized Study ◽  
Alternative Therapy ◽  
Renal Calculi ◽  
Stone Free Rate ◽  
Group 2 ◽  
Free Rate ◽  
Group 1

Abstract Objective Compare the outcomes of RIRS and PCNL for the treatment of 1 to 2 cm lower calyceal renal calculi regarding the stone free rate, operative time, fluoroscopy time, hospital stay and complication rate. Materials and Methods Patients with a single lower calyceal stone with an evidence of a CT diameter between 1 and 2 cm were enrolled in this randomized study. Patients were randomized into two groups: group 1: underwent RIRS (20pts); group 2: underwent PCNL (20 pts). Patients were evaluated with KUB and CT after one month. Results Mean fluoroscopy times and Hospital stay were significantly greater in the PCNL group than in RIRS group, In the RIRS group, the stone-free rate was 85% (17/20 patients); this rate increased to 95% after a second intervention. After a single PCNL procedure, 19 of 20 (95%) patients were completely stone free and For complications, there were minimal differences in both procedures, except for hemorrhage three patients who were treated with PCNL need blood transfusion Conclusions PCNL and RIRS are safe and effective methods for medium-sized LP calculi. For selected patients, RIRS may represent an alternative therapy to PCNL, with acceptable efficacy and low morbidity., RIRS compared to PCNL offers the best outcome in terms of radiation exposure and hospital stay.

scholarly journals A novel technique for measurement of orthodontic mini-implant stability using the Osstell ISQ device

2018 ◽  
Vol 89 (2) ◽  
pp. 284-291
Author(s):  
Yara K. Hosein ◽  
S. Jeffrey Dixon ◽  
Amin S. Rizkalla ◽  
Ali Tassi
Keyword(s):  
Gold Standard ◽  
The Novel ◽  
Stability Assessment ◽  
Implant Stability ◽  
Novel Technique ◽  
Implant Stability Quotient ◽  
Mini Implants ◽  
Repeatability And Reproducibility ◽  
Positive Correlations ◽  
The Stability

ABSTRACT Objectives: To develop and validate a method for application of the Osstell ISQ device in the assessment of mini-implant stability. Materials and Methods: An adaptor was developed for attachment of Osstell's SmartPeg onto a variety of orthodontic mini-implants. For validation of the adaptor, Benefit mini-implants were inserted into bone blocks that mimicked different stability conditions. The Osstell device was used to assess mini-implant stability with the adaptor (test measurement) and conventional SmartPeg attachment (gold-standard measurement). Implant stability quotient (ISQ) values were assessed for agreement, repeatability, and reproducibility. Results: Strong positive correlations were found between ISQ values obtained using the novel adaptor and the conventional attachment. Repeatability and reproducibility of ISQ values with the adaptor were similar to those obtained with the conventional attachment. Conclusions: A method was developed and validated to assess the stability of orthodontic mini-implants using the Osstell system. The novel mini-implant adaptor provided repeatable and reproducible measurements of mini-implant stability, which agreed with those obtained using a conventional SmartPeg attachment. This adaptor permits noninvasive stability assessment of various designs of mini-implants, most of which are incompatible with the conventional SmartPeg attachment.

scholarly journals Mini percutaneous nephrolithotomy: its role in the management of renal stone and our tertiary care centre experience

2020 ◽  
Vol 8 (2) ◽  
pp. 624
Author(s):  
Avinash Pratap Singh Thakur ◽  
Darsan S.
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Operative Time ◽  
Tertiary Care ◽  
Renal Calculi ◽  
Medium Size ◽  
Tertiary Care Centre ◽  
Excellent Outcome ◽  
Stone Fragmentation

Background: Miniaturized percutaneous nephrolithotomy (PCNL) procedures for urolithiasis have gained increased popularity in recent years. To decrease the complications of conventional PCNL by  reduced tract size led to the development of Mini PCNL, which makes the use of 15-18F sheaths in place of 24-30F of conventional PCNL. It has developed rapidly and become a popular technique of renal stone management with reduced morbidity and excellent outcome. Authors report our experience with Mini PCNL for the treatment of renal stone.Methods: In between his August 2015 and January 2018, sixty patients with the diagnosis of unilateral single medium size (8-20mm) renal stone were identified. Patient’s demographical, clinical, diagnostic and procedural data were recorded.  All patients were evaluated by history taking, physical examination and laboratory investigations. Radiological evaluation was done with X ray kidney, ureter and bladder region (KUB) and also with renal ultrasonography followed by computed tomography (CT). All patients underwent Mini PCNL using 12F nephroscope and 16.5/17.5F sheath. Holmium: YAG laser was used for stone fragmentation. No nephrostomy tube was used routinely. Treatment outcome was assessed in terms of operative time, haemoglobin drop, hospital stay and stone free rate.Results: Complete stone fragmentation was achieved in 41 out of 60 patients using Mini PCNL, so initial stone free rate was 68.3%. After 4 weeks of surgery total 53 patients were stone free (88.3%), 5 patients required some auxiliary procedure for complete clearance of stone and other 2 were managed conservatively. The mean operative time was 48.28 min, mean haemoglobin drop was 0.74gm/l and mean postoperative hospital stay was 54.22 hours. After 12 weeks postoperatively all patients were stone free. There were no significant postoperative complications, and all had good quality of life.Conclusion: Mini PCNL technique appears to be safe and effective alternative to conventional PCNL for moderate size renal calculi. It is usually related to less blood loss and shorter hospital stay than the standard method. It can achieve good stone-free rates with minimal complications and low morbidity. Mini PCNL can also be considered as a good alternative to retrograde intrarenal surgery and shockwave lithotripsy in selected cases. However, further high quality studies with larger sample size are required in future.

scholarly journals Clearance of Renal Stone in PCNL Under Spinal Anaesthesia

2020 ◽  
Vol 23 (2) ◽  
pp. 154-157
Author(s):  
Muhammad Hossain ◽  
Sayedul Islam ◽  
Mohammad Shafiqur Rahman ◽  
Faruk Hossain ◽  
Md Saiful Islam ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Spinal Anaesthesia ◽  
Renal Stone ◽  
Operative Time ◽  
Stone Disease ◽  
Female Ratio ◽  
Male Female Ratio ◽  
Minimal Complication ◽  
Age Range ◽  
Total Study Period

Objective: To evaluate the Outcome of PCNL under spinal Anaesthesia. Material and Method: A total of 74 patients with renal stone disease were treated by PCNL under spinal anasthesia. Total study period was from January 2013 to October 2019. Pre operative and post operative variables and complications were recorded. Result: Age range from 25 years to 65 years, mean 41.37 ± 33 yrs. Male female ratio was 6.4:1 stone size ranges from 15mm to 40mm, majority was 21.33mm. Mean operative time was 69±4.2 min. Total stone clearance was 15.60%. Only 10.82% patients were suffering from grade I complications and mean hospital stay was 3.1±0.6 days. Conclusion: Percutaneous nephrolithotomy is effective and safe under spinal anesthesia with shorter hospital stay and minimal complication. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.154-157

Comparison between open and laproscopic pyeloplasty in Al-Diwaniya Teaching Hospital

2018 ◽  
Vol 9 (SPL1) ◽  
Author(s):  
Ahmed Ali Al-Hamzawi
Keyword(s):  
Hospital Stay ◽  
Success Rate ◽  
Teaching Hospital ◽  
Gold Standard ◽  
Open Surgery ◽  
Operative Time ◽  
Ureteropelvic Junction Obstruction ◽  
Ureteropelvic Junction ◽  
Laparoscopic Pyeloplasty ◽  
Open Pyeloplasty

Background: Historically open pyeloplasty has been regarded as the gold standard for the surgical management of ureteropelvic junction obstruction (UPJO). The treatment of this condition has evolved considerably over the past two decades resulting in new surgical approaches. One of these approaches is laparoscopic pyeloplasty,this technique aimed to achieve the same results as open surgery,with lower rates of morbidity and complications.  Aim of the study: To compare the operative time,hospital stay,analgesic use,perioperative complications,and success rate between laparoscopic and open pyeloplasty in Al Diwaniya Teaching Hospital. Patients & Methods: From October 2014 to October 2016,40 patients (26 males and 14 females) with Ureteropelvic junction obstruction who had been admitted to the urology unit of Al Diwaniya Teaching Hospital were enrolled in this study. Their ages ranged from 10 to 44 years with a mean age of 24 years. The patients were selected on the basis of standard indications for PUJO repair. The patients were assigned into two groups. Twenty patients underwent transperitoneal laparoscopic pyeloplasty and 20 patients underwent open surgery. The choice between the two types of operation was selected according to surgeon's preference (only surgeon who has enough experience with laparoscopic surgeries perform laparoscopic pyeloplasty,while the other performed open surgery). Preoperative evaluations were done using abdominal ultrasound and IVP. Laboratory tests included urinalysis,urine culture,blood urea,and serum creatinine. Blood group was determined. We compared the operative time,complications rates,hospital stay and success rate of the two groups.Mean operative time was 2 hours and 3 hours in open and laparoscopic pyeloplasty groups,respectively. Mean hospital stay was shorter (24 hours) in the laparoscopic group and (48 hours) in open group. Mean follow-up period was 9 months. Postoperative complication rates were 20 % and 30 % in laparoscopic and open pyeloplasty groups,respectively. Success rates were 95% and 90 % for open and laparoscopic pyeloplasty groups,respectively. Repeated surgery was performed in 2 patients of laparoscopy and 1 of open pyeloplasty groups due to recurrence of stricture.The safety and efficacy of laparoscopic pyeloplasty is comparable to that of open pyeloplasty,with better cosmetic results and shorter hospital stay,therefore laparoscopic pyeloplasty can replace open surgery and may be considered the gold standard technique for the treatment of ureteropelvic junction obstruction in expert hands.

scholarly journals Laparoscopic Versus Open Appendicectomy for Treatment of Acute Appendicitis

2019 ◽  
Vol 20 (1) ◽  
pp. 24-25
Author(s):  
Mohammad Ali ◽  
Kazi Lsrat Jahan
Keyword(s):  
Acute Appendicitis ◽  
Hospital Stay ◽  
Gold Standard ◽  
Operative Time ◽  
The Other ◽  
Laparoscopic Appendicectomy ◽  
Abdominal Abscess ◽  
Open Appendicectomy ◽  
Laparoscopic Skills ◽  
Operative Complications

Laparoscopic appendicectomy is not yet considered the "gold standard" in the treatment of acuteappendicitis because of its higher operative time, intra-abdominal abscess risk, and costscompared to open appendicectomy. On the other hand laparoscopic appendicectomy is associatedwith fewer post operative complications, shorter hospital stay, and nearly similar operative time,intra-abdominal abscess rate, and total costs, compared with open appendicectomy. With increasein the experience of the surgeon in laparoscopic skills pit falls will be much lower. Therefore, laparoscopicappendectomy can be recommended as preferred approach in acute appendicitis Journal of Surgical Sciences (2016) Vol. 20 (1) : 24-25

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