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    Laparoscopy assisted percutaneous stone surgery can be performed in multiple ways for pelvic ectopic kidneys
    (Springer, 2016) Soylemez, Haluk; Penbegül, Necmettin; Utangac, Mehmet Mazhar; Dede, Onur; Cakmakci, Suleyman; Hatipoglu, Namik Kemal
    Pelvic kidney stones remain a unique challenge to the endourologists. Treatment options include open surgery, extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy (PNL), retrograde intrarenal surgery, and laparoscopy assisted PNL (LA-PNL). As a minimal invasive option, LA-PNL can decrease the risk for bowel and major vessel injury. Here, we describe our experience using the LA-PNL procedures with different combinations, to treat kidney stones in multiple patients with a pelvic ectopic kidney (PEK). Eight patients, with PEK, kidney stones, and no other treatment choice, but open surgery, were included in the study. Two different laparoscopic techniques such as mesocolon dissection and transmesocolic, and four different percutaneous procedures such as standard-PNL, mini-PNL, micro-PNL, and a PNL through the renal pelvis were used for stone extraction in these patients. The mean age of patients was 25.6 +/- 12.9 years and mean stone size was 524.1 +/- 430.3 mm(2). Mean operation time was 150.5 +/- 40.0 (77-210) min which was composed of retrograde catheterization (14.8 +/- 2.9 min), laparoscopic procedure (48.7 +/- 20.6 min) and PNL procedure (86.8 +/- 31.1 min). Residual stones were seen in two patients (no additional treatment was need), while a 'stone-free' procedure was achieved in six patients (75.0 %). On the post-operative first month visit, a stone was observed on radiological examinations in only one patient (87.5 % stone-free). Mean hospitalization time was 2.8 +/- 0.9 days. No perioperative or post-operative complication was observed in all patients. LA-PNL surgery is a safe and effective option for treatment of PEK stones, and has several alternative approaches.
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    Öğe
    Microsheath for Microperc: 14-Gauge Angiocath
    (Mary Ann Liebert, Inc, 2013) Penbegül, Necmettin; Bodakci, Mehmet Nuri; Hatipoglu, Namik Kemal; Sancaktutar, Ahmet Ali; Atar, Murat; Cakmakci, Suleyman; Yildirim, Kadir
    Micropercutaneous nephrolithotomy (microperc) is the end point percutaneous nephrolithotomy (PCNL) technology for the present. In routine PCNL surgery, use of an Amplatz sheath is an important step, but in this technique, there is no Amplatz sheath. Some problems during surgery may occur because of the lack of an Amplatz sheath, which provides a tract between the skin and the collecting system. Therefore, we describe the smallest Amplatz sheath (6.6F) that is compatible with the microperc instrument and can be used during percutaneous surgery, especially in preschool pediatric patients.