Introduction: Nephrostomy insertion is a vital part of modern-day urology used to manage obstructedrenal tract or gain percutaneous renal access.Method: We carried out a PubMed literature search on the history of the development of nephrostomies. Results: The first percutaneous nephrostomy was performed in 1864 on a child who died in 5 years. Nephroscopy was then described and performed in 1941 during an open surgery with subsequent advancement to percutaneous nephrolithotomy in 1976 and antegrade stent insertion in 1978.Conclusion: Clinical need and innovation have led to percutaneous renal access and subsequent stone treatment modality.
Abstract
Background: Percutaneous nephrolithotomy , (PCNL) is a common urological procedure for dilatation of access during one shot PNL. Methods : Our research is over twenty one cases of one shot visually guided tract dilation PCNL who referred to Sina Hospital between 2017,2018. They all underwent surgery using a specific 28 F dilatators with a customized central lumen which accepts a 4.5 F semi rigid ureteroscope to visually confirm the puncture of target calyx and passing a guide wire. This instrument complex was passed as a one shot dilator after withdrawal of the puncture needle. Results: The mean duration time form insertion of a needle into target calyx until securing a guide –wire inside the collecting system (pelvis, ureter) and the mean time form needle withdrawal to successful dilation and sheath placement were 95 and 252 seconds respectively. There were no intraoperative or postoperative complications a result of this technique. There was no false passage or failed accesses .Total fluoroscopy time for percutaneous access was reduced considerably. Conclusions: Use of modified ureteroscope kit during PNL, for visually confirmed Percutaneous nephrolithotomy , (PCNL) is feasible especially on complex calycealstones or pelvicalyceal Anatomies occasions.
Evolution of Percutaneous Renal Access