Visual Dilatation Technique in Percutaneous Nephrolithotomy: An Initial Clinical Experience

Abstract

Abstract Introduction and Objectives: Tract dilatation is a crucial step in percutaneous nephrolithotomy, which can be guided under fluoroscopy, ultrasound, or combination of both techniques. It can still be difficult to ascertain the optimal depth to prevent overdilation, causing collecting system perforation and vascular injury or underdilation, making the establishment of access tract in a single attempt strenuous.1–7 Here, we present our initial clinical experience in using the novel technique of visual dilator system to obtain real-time visual confirmation of accuracy during percutaneous tract dilatation. Material and Methods: The visual dilator system used consisted of a transparent hollow dilator made of polyvenyl chloride and a 12F mini nephroscope inserted within its lumen. The nephroscope was connected to standard endoscopic camera system. The dilator system backloaded with access sheath was passed over guidewire to dilate percutaneous tract and position the access sheath under visual guidance. ...