Department of Urology, MPUH, Nadiad, India.
J Endourol. 2022 Sep;36(S2):S35-S40. doi: 10.1089/end.2022.0299.
Percutaneous nephrolithotomy (PCNL) has evolved many a fold and was originally described in supine position by Valdivia et al. In this position, the direction of the tract is posterior and thus preserves a low pressure in the renal pelvis, and thereby reduces the risk of fluid absorption and allows spontaneous clearance/washout of fragments by gravity-directed flow of fluid. Supine PCNL is feasible in most situations. It is an important tool for patients who have musculoskeletal abnormalities precluding prone positioning. It gives the surgeon a simultaneous opportunity to do flexible ureteroscopy. Mobility of the kidney may make the puncture difficult. Suctioning of the dust using the suction sheath in supine PCNL makes the procedure more effective.
经皮肾镜碎石术 (PCNL) 已经有了很大的发展，最初由 Valdivia 等人在仰卧位下描述。在这个位置，通道的方向是向后的，因此可以保持肾盂内的低压力，从而降低液体吸收的风险，并允许碎片通过重力引导的液体流动自然清除/冲洗。仰卧位 PCNL 在大多数情况下都是可行的。对于那些因骨骼肌肉异常而不能俯卧的患者，它是一种重要的工具。它为外科医生提供了同时进行软性输尿管镜检查的机会。肾脏的移动性可能使穿刺变得困难。在仰卧位 PCNL 中使用吸引鞘抽吸灰尘可以使手术更有效。
