Abstract
Background: Treatment of upper urinary tract stones measuring >2 cm in children aged <3 years is challenging. Although adult-sized instruments are usually available, in pediatric populations such instruments seem unreasonable and unfit for children with small kidneys and narrow ureters. We use ultra-miniaturized endoscopes and instruments to reduce the damage to normal tissues in pediatric patients.Case Presentation: We treated a 2-year-old boy with >2-cm bilateral cystine kidney stones. We decided to perform retrograde intrarenal surgery using an ultrathin (4.5F) semi-rigid ureteroscope for the right kidney stone (2.0 × 1.2 cm) in the lithotomy position and super ultra-minimally invasive endoscopy combined with intrarenal surgery with a percutaneous 8.5F to 9.5F tract sheath for the left kidney stone (3.5 × 2.4 cm) under the Barts modified Valdivia position. These procedures were successful for the bilateral kidney stones. Postoperatively, the patient was stone-free without major complications.Conclusion: We believe that ultra-minimally invasive endoscopic intrarenal surgery is safe and efficient in pediatric patients. Furthermore, the Barts modified Valdivia position was safely utilized in our 2-year-old patient with multiple large kidney stones.
Highlights
In pediatric patients, extracorporeal shockwave lithotripsy (SWL) under general anesthesia is usually the first treatment for kidney and proximal ureteral stones of
We decided to perform retrograde intrarenal surgery using an ultrathin (4.5F) semi-rigid ureteroscope for the right kidney stone (2.0 · 1.2 cm) in the lithotomy position and super ultra-minimally invasive endoscopy combined with intrarenal surgery with a percutaneous 8.5F to 9.5F tract sheath for the left kidney stone (3.5 · 2.4 cm) under the Barts modified Valdivia position
We believe that ultra-minimally invasive endoscopic intrarenal surgery is safe and efficient in pediatric patients
Summary
Extracorporeal shockwave lithotripsy (SWL) under general anesthesia is usually the first treatment for kidney and proximal ureteral stones of
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