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Limitation of motion (puncture needle in supine position)

February 2, 2018

M/40yr, Referred for stone removal 

 

NCCT: LKUPost (x3, 7/3/1mm), LKMAnt (x1, 11x10x10mm), LKLPost (x1, 11x11x10mm), HU 1,451, severe hydronephrosis

 

 

Preoperative CT (coronal)

 

Direct puncture to the lower pole anterior stone was not available because the needle was disturbed by the upper brim of the pelvic bone when I consider the angle from pelvic bone via LP stone to renal pelvis. 

 

I planned to approach the LP anterior stone via LP post calyx but....

 

RIRS as a plan B. How about Prone PCNL?

 

 

 

 

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Basketing and Dusting

February 4, 2016

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