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Review
. 2018 Sep;59(5):348-354.
doi: 10.4111/icu.2018.59.5.348. Epub 2018 Jul 16.

Real-time simultaneous endoscopic combined intrarenal surgery with intermediate-supine position: Washout mechanism and transport technique

Hae Do Jung  1 , Jong Chan Kim  2 , Hyun Kyu Ahn  2 , Joon Ho Kwon  3 , Kichang Han  3 , Woong Kyu Han  2 , Man-Deuk Kim  3 , Joo Yong Lee  1
Affiliations
Review

Real-time simultaneous endoscopic combined intrarenal surgery with intermediate-supine position: Washout mechanism and transport technique

Hae Do Jung et al. Investig Clin Urol. 2018 Sep.

Abstract

Endoscopic combined intrarenal surgery (ECIRS) with simultaneous retrograde intrarenal surgery (RIRS) and percutaneous nephrolithotomy (PCNL) has been proposed as a new surgical treatment to overcome the disadvantage of RIRS and PCNL monotherapies in the treatment of renal stone. One of advantages of ECIRS is that it can increase stone-free rates in complex renal stone within single-session. Intermediate-supine position in real-time simultaneous ECIRS can prevent an anesthesiologic problem, and patient's burden is small even for long-term operation. Thus, we will share the experience and advantages of real-time simultaneous ECIRS and introduce techniques to increase the stone-free rate.

Keywords: Kidney; Nephrolithiasis; Ureteroscopy; Urinary calculi.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. The endoscopic combined intrarenal surgery was performed with the patient under general anesthesia in the intermediate-supine (Galdakao-modified supine Valdivia) position. The patient was placed in the supine position with a 1-L saline bag below the ipsilateral flank.
Fig. 2
Fig. 2. During real-time simultaneous endoscopic combined intrarenal surgery, nephroscope and flexible ureterorenoscope can take finger-touch to see each other. The appearance of the two endoscopes facing each other is similar to the fingertip in the movie E.T., and we named it finger-touch.
Fig. 3
Fig. 3. With real-time simultaneous endoscopic combined intrarenal surgery, when the nephroscope is removed from the Amplantz sheath, fragmented stones exit through the sheath (arrow direction).
See this image and copyright information in PMC

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