MICROPERC (THE LOGICAL EVOLUTION)
==inizio abstract==
1-Objective
The Micronephrolithotripsy represent the logical evolution of the Percutaneous Treatment in special cases of renal stones. We present our experience on eleven patients.
2-Methods and results
From November 2013 to February 2014 we perform 11 interventions of Microperc. The age of patients ranged from 3 to 52 years.The procedure provides access to the kidney under ultrasound or fluoroscopic guidance, through the micro-optical system and 3-part “all-seeing needle” consisting of a needle, a spindle and a work shirt (4.85 Fr) that allows the insertion of a micro-optic (diameter 0.9 mm), width viewing angle of 120° and a high resolution. A 3-way adapter is also connected to the portion proximal of the instrument for the application of an irrigation pump over that of the fiber optics and laser Holmium for the shuttering of the stones. The dimension of the stones ranged from 1.5 (2 pediatric patient) to 3.2 cm. All patients was discharged 2 days after the operations. 8 patients had hematuria in the first 24 hours. In one case there was serious hematuria, resolved spontaneously. The control counts and renal function after surgery was in the normal range for all patients. The operating time ranged from 2 hours and 40 minutes.
3-Discussion
The PCNL is considered the most effective treatment for kidney stones larger than 2 cm, but it can sometimes present risk of bleeding. The microperc is its logical development, with the aim to reduce this complication. Also plays, and in our opinion will play more and more, a valid approach in the calculi refractory to shock waves and in pediatric stones. In the early stages of approach it appears to be easier to implement than the RIRS and with times significantly shorter
4-References
Sabnis RB and others: Micropercutaneous nephrolithotomy (microperc) vs retrograde intrarenal surgery… BJU Int. 2013 Aug;112(3):355-61.
==fine abstract==
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