Difficult Renal Puncture: Geometrical Study


Authors : Jihad El Anzaoui; Chatar Achraf; Abdelghani Ammani; Akajai Ali; Amaziane Ahmed; Lakrabti Naceur; Habyebete Soufiane

Volume/Issue : Volume 6 - 2021, Issue 12 - December

Google Scholar : http://bitly.ws/gu88

Scribd : https://bit.ly/3n8sjOa

The fluoroscopic guidance of percutaneous nephrolithotomy (PCNL) is a worldwide known procedure. Currently, more and more practitioners perform renal puncture in monoplanar fluoroscopic projection without need of moving the Carm. The depression of the tip of he calyx is the proof of the perfect position of the needle. However, in the case of dificult renal puncture, the surgeon or the radiologist is forced to manipulate the Carm to delineate the position of the needle either it is anterior or posterior to the calyx. The interpretation of the fluoroscopic view is still sometimes subject to confusion especially for nonexpert urologists. : the understanding of fluoroscopic findings is based on geometrical considerations. the authors propose a well-illustrated essay trying to explain the movement of the C-arm in case of failed calyceal puncture in diferent directions. : the surgeon or the radiologist needs after asessement of the first puncture, to move the C-arm in his preferred plan to delineate precisely in which location is the needle in relation to the calyx and adjust accordingly the position of the needle.

Keywords : Image guided surgery, urinary stone, fluoroscopy, percutaneous nephrolithotomy, percutaneous nephrostomy.

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