Abstract
ObjectiveTo report our experience of hydro-dissection ultrasonography (US)-guided percutaneous nephrolithotomy (HU-PCNL) used to facilitate entry to the pelvi-calyceal system (PCS) and optical HU-PCNL (OHU-PCNL) to visualise tissue layers during PCS entry. Both HU-PCNL and OHU-PCNL are used for difficult cases of renal stones that are not candidates for classical PCNL by use of US guidance, e.g. in obese patients, horseshoe kidney, ectopic pelvic kidney, transplanted kidney, and lower calyx stones covered by colon; and used in ectopic pelvic kidney PCNL to avoid abdominal organs injury. OHU-PCNL visualises the stone directly at the moment of entry to the PCS then passes the infundibulum, enters the pelvis, and allows selection of the optimum side for guidewire insertion. OHU-PCNL avoids colonic injury and if the needle perforates the colon it can be seen allowing removal of the needle and a change in direction.
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