Login to Access Video or Poster Abstract: MP68-14
Sources of Funding: none

Introduction

_x000D_ _x000D_ A standard Percutaneous Nephrolithotomy is the standard of care for renal calculus especially those more than 2 cm, which involves the patient in prone position with percutaneous access. In addition to this technique various techniques of using miniaturised scopes and instruments have been described in both prone and supine position.We present our series of mini PCNL in supine postion._x000D_ _x000D_ _x000D_ _x000D_ A observational study was done to evaluate the efficacy, safety and outcomes of supine mini PCNL(smPCNL) in our patients

Methods

200 patients underwent smPCNL over a period of 3 years including both retrsospective and prospective cohorts were analysed. Data collection included stone size & location, anaesthesia & operative time, use of stent/ureteric catheter, length of hospital stay, stone clearance & complications.Cases were performed using mini PCNL set, in Galdakao-modified Supine Valdivia / modified supine position using fluoroscopy. Success was defined as patients free of stones or with residual stone fragments <5mm.

Results

The mean stone size was 2.7 cm. There were 36 cases with stone located in a single calyx, while 4 case with stones in multiple calyces . Pelvic stones were 50 in number, while pelvi-calyceal/pelvi-uretric stones were 61 in number. 28 upper uretric stones with 17 bilateral renal unit stones were present; while there were 4 each of upper calyceal diverticulum stone and upper ureter plus calyceal stone. 93% of the cases required a single puncture while frequency of lower calyceal and middle calyceal puncture was 53% and 42 % respectively. Complete stone clearance was achieved in 190 cases (95%) with 10 cases having residual fragments which were treated with ESWL. 30 cases had simultaneous PCNL & URS for stone clearance. 75% cases were totally tubeless. Mean hospital stay was 2.15 days & overall complication rate was 9% which included bleeding, sepsis etc.5% of patients were discharged from the day care room.

Conclusions

smPCNL is safe and effective in suitable patients and offers good stone clearance with minimal morbidity.

Funding

none