Abstract
The purpose of this study is to describe a technique to determine the site of skin puncture for sub-costal percutaneous renal access using a fluoroscopy-guided triangulation technique. Using the bull's-eye technique under fluoroscopy guidance, the distance of skin puncture from the targeted calyx is determined. Then this distance is utilized in the triangulation technique to determine the site of skin puncture. Since July 2007 to February 2008, 30 cases were done using this technique. Successful access was accomplished in all cases in alignment with the infundibulum. Lower pole access was achieved in 21 cases and midpole access was achieved in 9 cases. This technique helps to determine the correct site of skin puncture in the fluoroscopy-guided triangulation technique. It leads to a tract that is of optimum length, proper direction, and is in alignment with the infundibulum.
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