Specialized Endoluminal-Endourology Stone Clinic (SEES)
최초의 결석-내시경 전문연구센터,
국내 유일의 결석실험실
(2019 Mar - Present. Organized by Pf. Sung Yong CHO)
Seoul National University Hospital
Kidney Stone Center
SMG-SNU Boramae Medical Center
국내최초 결석-내시경 전문센터
(2017~2019. Organized by Pf. Sung Yong Cho)
(2019.Mar~ Present. Now with Pf. Minsoo Choo)
결석 / 내시경 전문 센터
결석 내시경 센터는 체외 충격 파쇄기, 연성내시경 및 미세신장경 등의 최신 장비를 구비하고 신장, 요관, 방광결석의 완전한 제거와 재발방지를 목표로 개인별 맞춤 진료를 제공하고 있습니다. 국내 최초로 최소침습 신장결석 수술 1,000례 달성 (2017년 2월), 라이브 수술시연 등 국내외 결석 치료의 선도적 역할을 수행하고 있습니다.
Kidney Stone & Endourology Center
Established in 2017, the Center is leading minimally invasive stone surgeries and provides personalized treatments for complete control of urinary calculi by using shock wave lithotripsy, flexible ureteroscopy and percutaneous nephrolithotomy.
Mission
The mission is to boost the confidence in people for managing and treating urinary stones and hypertrophied prostate and ultimately increase patients' Quality of Life.
Vision & Core Values
'Specialized Endoluminal- Endourology Stone Center' provide Best- in- Class stone and BPH treatment to patients and deliver optimised outcome through the proven processes.
'Specialized Endoluminal - Endourology Stone Center' tries to invigorate endourologists to be able to perform all kinds of stone surgery including minimally invasive surgical cases of Flexible Ureteroscopy, miniaturized-PCNL, and Combined (Antegrade and Retrograde)Approaches.
'Specialized Endoluminal - Endourology Stone Center' tries to provide interactive information on endourological stone and prostate surgery, in which we hope will contribute to the advance urologic health and education.
Professional
Up-to-date with the latest knowledge and treatment
Excellence
Continuous improvement on the standards and processes.
Integrity
Operate at higest level of honesty and responsibility.
Respect
Treat people with dignity and respect.
Caring
Listening carefully to otheres and working together to achieve goals.
Stone Treatments / 결석치료법
Shockwave Lithotripsy (SWL)
Up to now, shockwave lithotripsy (SWL) was the first choice in cases of renal stones of size < 20 mm and is generally performed in an outpatient department with the patient under local or general anesthesia.
However, SWL is not appropriate to patients with very hard stones and resistance to breakage with SWL, stones invisible on X-ray, (such as cystine, monohydrate or uric acid stones), and very large stones. Additionally, patients who are on blood-thinning medications or who may be pregnant should not undergo SWL procedures.
Retrograde Intrarenal Surgery (RIRS)
RIRS (retrograde intrarenal surgery) is a surgical procedure for management of renal stone or tumor. Urologists perform surgery within the kidney using a flexible ureterorenoscope. Therefore, this procedure is also called as 'flexible transurethral lithotripsy (f-TUL)'.
This endoscope is placed through the urethra, bladder, ureter and the urine-collecting part of the kidney. We call this a retrograde approach. Renal stones or tumors can be observed through the endoscope, removed by a laser and a small basket.
RIRS (retrograde intrarenal surgery) surgical guide video (2016 update)
Percutaneous Nephrolithotomy (PCNL)
PCNL (percutaneous nephrolithotomy) is another surgical procedure for management of renal stones. Urologists can remove large and complex renal calculi using a single or multiple holes in the flank area of patients. The conventional size for each hole is 1 cm and these can induce bleeding, postoperative pain, and potential renal damage in limited cases.
The PCNL can be performed with a miniaturized endoscope via a smaller percutaneous tract (<6mm). This was named as "minimally invasive" or mini-PCNL.
Renal Stone - Pre operative considerations
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Infection
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Anticoagulation
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Obesity
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Hardness of stones
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Radiolucent stones
Decision - ESWL vs. Surgery
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ESWL vs. Surgery (PCNL, RIRS)
When you consider active removal of urinary stones, ESWL would be the first option.
However, in cases of multiple, large, or hard stones that cannot easily be removed by ESWL, you woldd consider the surgical treatment of RIRS or PCNL.
You should also consider surgery if you are under special situations/conditions such as planning a trip abroad, taking anticoagulant drugs, or having some unfavorable anatomy to spontaneous stone passage.
Decision - RIRS vs. MPCNL
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RIRS vs MPCNL
Until now, there have been no definite indications that differentiated RIRS and MPCNL. However, you would consider (M)PCNL when you have large or staghorn stones, ureteral narrowing or abnormality, history of undergoing ileal conduit, or etc.
MPCNL and RIRS are safe and feasible surgical options for managing small-to-mid sized stones; the roles of these operations are expanding.