A NEW OPERATIVE METHOD: PERCUTANEOUS NEPHRO-URETEROLITHOTOMY USING AN ULTRASONICALLY-GUIDED PUNCTURE TECHNIQUE

摘要

In 1980, an ultrasonically-guided percutaneous pyeloscopy method was developed at our clinic. This suggested the possibility of several kinds of intrarenal instrumentations byendoscopic guidance. Recently, we developed a new method for percutaneous stone removal under pyeloscopic control. A flexible fiberoptic bronchoscope was introduced directly into the renal pelvis through a trocar under ultrasonic realtime guidance. The fiberscope was introduced into the ureter from the ureteropelvic junction. The stone situated in the upper portion of the ureter was trapped by the stone basket which was directed to the stone through the forceps channel of the bronchoscope. The stone was timely extracted under endoscopic control. This direct percutaneous method without pre-establishing nephrostomy made possible a non-invasive operation with a very small skin incision for urinary stones.