APPLIED GEOMETRY MATH FOR TECHNICAL TO PUNCTURE THE NEEDLE INTO THE RENAL CALYCES IN PERCUTANEOUS NEPHROLITHOTOMIES

Objectives: To evaluate the technique to puncture the needle into the renal calyces based on the CT-Scanner images and only used the C-arm on the principles of geometry in PCNL. Materials and Methods: 86 cases of percutaneous nephrolithotomies have been performed at Department of Urology of Hue Central Hospital from June 2014 to May 2017. Results: Mean age 47.3 ± 12.7 years (23 - 71). Renal pelvis stones: 15 cases (17.4%), renal calyx stones: 9 cases (10.5%), staghorn stones: 24 cases (27.9%) and renal pelvico-calyx stones: 38 cases (44.2%). Grade of hydronephrosis: grade I: 27 cases (31.4%), grade II: 31 cases (36.0%), grade III: 9 cases (10.5%), no hydronephosis 19 cases (22.1%). For making dilatation, we puncture into inferior posterior of the kidney in 41 cases (47.7%), middle calyx 37 cases (43.0%) and superior calyx 8 cases (9.3%). Average time to puncture 17 ± 18 seconds (fastest 3 seconds and slowest 156 seconds). Not used urinary contrastion: 14 cases (16.3%), and used it for 72 cases (83.7%). PCNL was successful 100%. Conclusions: The technique to puncture the needle into the renal calyces based on the CT-Scanner images and only used the C-arm fluoroscopic on the principles of geometry in PCNL is good technique with fastly and exactly result. Key words: : percutaneous nephrolithotomies (PCNL), Hue Central Hospital, renal calyces

Percutaneous Endoscopic Lumbar Discectomy for Far-Migrated Disc Herniation through Two Working Channels

The technique of percutaneous endoscopic lumbar discetomy (PELD) in the transforaminal approach has evolved over the years due to the advances in endoscopic photology and instrumentation and become the most popular technique for lumbar disc herniation. Although PELD offers many advantages, the indications of PELD are limited mostly to non-migrated or low-migrated disc herniation. It is very difficult for PELD in the transforaminal approach to remove the highly migrated disc fragment successfully due to the anatomic barrier. Nowadays, with the advances of instruments and technique, it might be possible for PELD in the transforaminal approach to remove these high-grade migrated disc fragments. The purpose of this study was to describe a technique to effectively treat highly migrated disc herniation via 2 working channels. Key words: Percutaneous endoscopic lumbar discectomy, far-migrated disc herniation, working channels