Ultra-mini Pcnl with clear Petra® suction–evacuation access sheath and warming irrigation fluid system (Rocamed®) for stone treatment in children

Abstract

Inadvertent perioperative hypothermia (a drop in core temperature to below 36°C) occurs because of interference with normal temperature regulation by anaesthetic drugs, skin exposure for prolonged periods and the introduction of large volumes of intravenous and irrigation fluids. If the temperature of these fluids is below core body temperature, they can cause significant heat loss. Warming irrigation fluids might prevent some of this heat loss and subsequent hypothermia and that is the role of warming irrigation fluid systems. The video describes prone ultra mini PCNL with suction-evacuation access sheath under warming irrigation fluid system in a 15 month-old boy with a 2cm-600HU staghorn calculi and one stone of 7mm-500HU in proximal ureter. The surgery was performed without intraoperative complications and perioperative hypothermia was prevented. The patient started the surgery at 35.4°C and the final temperature was 36.3°C in 90min of procedure, in addition to being free of stones. The warming irrigation fluid system can be helpful in preventing inadvertent perioperative hypothermia in children, improving the safety of ultra mini PCNL with suction-evacuation access sheath and shows promising results with high stone-free rates and low complications.