Supine Percutaneous Nephrolithotomy and ECIRS
PNL is the gold standard for the management of large and/or otherwise complex renal stones. Since its introduction in the seventies PNL has undergone considerable evolution, mainly driven by the improvement in access techniques, endoscopic instrument technology, lithotripsy devices and drainage management. The conventional prone position for PNL has been challenged in the last two decades by a variety of modifications, including the supine and Galdakao-modified supine Valdivia positions, which make simultaneous retrograde working access to the collecting system possible and have proven anesthesiological advantages. The Galdakao-modified supine Valdivia position allowed the development of ECIRS (Endoscopic Combined IntraRenal Surgery), a technique exploiting a combined antegrade and retrograde approach to the upper urinary tract, using both rigid and flexible endoscopes with the related accessories. The synergistic teamwork of ECIRS provides a safe and efficient, minimally-invasive procedure for the treatment of all kinds of urolithiasis.
The aim of this book is to share with the urologic community worldwide our experience, our standardization of all the steps, and tips and tricks for the procedure.
First book dealing with supine PNLThe supine position with its modifications is the basis for ECIRS (Endoscopic Combined Intra-Renal Surgery)This book describes in detail the surgical technique step by step, all the instruments and accessories to be employed, the organization of the operating room, the application of this surgical approach to special cases (malignant conditions, malformations, obesity, renal transplant…) The preoperative assessment of the patient for a correct indication (anatomic study from radiological images), is analyzed It presents a wide preliminary revision of the recent literature with the current state of the art The authors propose numerous video-clips illustrating the written material All contributors are opinion leaders of the field of endourology