Abstract
BackgroundBroken basket during retrograde intrarenal surgery (RIRS) is a known complication. The literature regarding this common complication is limited. We report a case of broken basket and explain the technique by which we retrieved the broken basket fragment that was entrapped around the calculus. We also analyze at the prevention strategies and better management strategies.Case presentationA 62-year-old male underwent RIRS for a 2-cm right renal lower calyceal calculus. A tipless nitinol stone basket got broken and distal part got entrapped around the calculus when basketing was attempted. We proceeded with stone fragmentation by RIRS. After complete stone fragmentation, another tipless nitinol stone basket was used to grab the broken tip of distal basket fragment which was lying in the renal pelvis. The broken basket fragment could be retrieved out in toto.ConclusionsBasketing large lower calyceal calculus should be attempted with caution. Partial or complete fragmentation of large calculus is preferable before basketing attempt. If the calculus is entrapped rather than forceful pulling, cutting the basket proximally near to the handle, followed by stone fragmentation, could minimize complications. Locating the broken tip of the basket fragment and grasping it makes the retrieval easier and safer.
Highlights
Broken basket during retrograde intrarenal surgery (RIRS) is a known complication
Basketing large lower calyceal calculus should be attempted with caution
Despite being a relatively common complication, the literature regarding real-time experiences, preventive and management strategies regarding this problem is limited. We report this case where we had to deal with this complication of the broken basket during RIRS and discuss the method which we used to retrieve the broken basket fragment
Summary
Basketing large lower calyceal calculus should be attempted with caution. Partial or complete fragmentation of large calculus is preferable before basketing attempt. If the calculus is entrapped rather than forceful pulling, cutting the basket proximally near to the handle, followed by stone fragmentation, could minimize complications. Locating the broken tip of the basket fragment and grasping it makes the retrieval easier and safer
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