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Advances in Urology
Volume 2016 (2016), Article ID 3840697, 8 pages
Research Article

Ultrasound Guidance for Renal Tract Access and Dilation Reduces Radiation Exposure during Percutaneous Nephrolithotomy

1Department of Urology, University of California, San Francisco, 400 Parnassus Avenue, Suite A610, P.O. Box 0330, San Francisco, CA 94143, USA
2Department of Urology, Tsinghua Changgung Hospital, Beijing 100034, China
3Division of Urology, Department of Surgery, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Rama IV Road, Patumwan, Bangkok 10330, Thailand

Received 29 October 2015; Revised 10 February 2016; Accepted 14 February 2016

Academic Editor: Mohammad H. Ather

Copyright © 2016 Thomas Chi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purposes. To present our series of 38 prone percutaneous nephrolithotomy procedures performed with renal access and tract dilation purely under ultrasound guidance and describe the benefits and challenges accompanying this approach. Methods. Thirty-eight consecutive patients presenting for percutaneous nephrolithotomy for renal stone removal were included in this prospective cohort study. Ultrasonographic imaging in the prone position was used to obtain percutaneous renal access and guide tract dilation. Fluoroscopic screening was used only for nephrostomy tube placement. Preoperative, intraoperative, and postoperative procedural and patient data were collected for analysis. Results. Mean age of patients was years. Forty-five percent of patients were male with mean BMI of and mean stone size of millimeters. Renal puncture was performed successfully with ultrasonographic guidance in all cases with mean puncture time of seconds. Mean dilation time was  min and mean stone fragmentation time was  min. Mean total operative time was . No patients experienced any significant immediate postoperative complication. All patients were rendered stone-free and no additional secondary procedures were required. Conclusions. Ultrasound guidance for renal access and tract dilation in prone percutaneous nephrolithotomy is a feasible and effective technique. It can be performed safely with significantly reduced fluoroscopic radiation exposure to the patient, surgeon, and intraoperative personnel.