1104 THE HISTORY AND EVOLUTION OF PERCUTANEOUS NEPHROLITHOTOMY

Abstract

You have accessJournal of UrologyHistory of Urology Forum1 Apr 20131104 THE HISTORY AND EVOLUTION OF PERCUTANEOUS NEPHROLITHOTOMY Sutchin R Patel, and Stephen Y Nakada Sutchin R PatelSutchin R Patel Madison, WI More articles by this author , and Stephen Y NakadaStephen Y Nakada Madison, WI More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.696AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Serendipity, innovative physicians, evolving techniques for renal access and improvements in equipment and radiology led to the evolution of percutaneous nephrolithotomy (PCNL). METHODS We searched urology texts and the current literature for sources pertaining to the history and development of PCNL. RESULTS In 1941, Rupel and Brown performed the first nephroscopy when a rigid cystoscope was passed through a nephrostomy tract and residual stones were removed following open surgery. Well known urologist Willard Goodwin, in 1955, while trying to perform a renal arteriogram, placed a needle into the collecting system of a hydronephrotic kidney and performed the first antegrade nephrostogram. He left a tube to drain the kidney, thereby placing the first nephrostomy tube By 1976, Fernström and Johansson were the first to describe a technique for extracting renal calculi through a percutaneous nephrostomy under radiological control. In 1978, Arthur Smith would describe the first antegrade stent placement when he introduced a Gibbons stent through a percutaneous nephrostomy in a patient with a reimplanted ureter with a urine leak to allow the urinary leak to seal. Dr. Smith would coin the term “endo-urology” to describe closed, controlled manipulation of the genitourinary tract. His collaboration with Kurt Amplatz, an interventional radiologist and medical inventor, would lead to numerous innovations which would further advance PCNL. In the 1980s the process of renal access and tract dilation was improved upon and the use of a rigid cystoscope was replaced by offset nephroscopes with a large straight working channel. Francisco Sampaio's casts of the renal collecting system and vascular anatomy in human cadavers would further aid urologists in obtaining access to the collecting system while minimizing the risk of bleeding in the 1990s. The introduction of fiber optics led to the utilization of flexible nephroscopy to aid in less invasive stone clearance, while radiographic innovations, from improvements in fluoroscopy to the use of pre-operative computed tomography, would further aid in renal access. The development of various lithotripsy devices (ultrasonic, pneumatic, combined) and the introduction of the holmium laser improved the efficacy of stone fragmentation and clearance. The increased clinical experience and utilization of PCNL would further lead to the characterization of stone free rates and complications for the procedure. CONCLUSIONS Serendipity, innovations in renal access, optics, radiology and improvements in lithotripsy all contributed to the modern day PCNL. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e452 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Sutchin R Patel Madison, WI More articles by this author Stephen Y Nakada Madison, WI More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...