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A Technique to Flush Out Stone Fragments Through a Ureteral Access Sheath During Retrograde Intrarenal Surgery
Published Web Location
https://doi.org/10.1089/cren.2019.0059Abstract
Background: Retrograde intrarenal surgery (RIRS) has become the preferred treatment option for selected renal stones <20 mm. However, laser fragmentation of stones often results in residual small fragments that may prompt subsequent stone events. We describe a simple technique to facilitate removal of these fragments. Case Presentation: A 68-year-old woman underwent elective RIRS for a 13 mm right renal pelvic stone. After laser fragmentation of the stone there were numerous <2 mm fragments too small to allow removal by a standard retrieval basket (i.e., NCircle® and NCompass® Nitinol Stone Extractors, Cook Medical, Bloomington, IN). A smaller ureteral access sheath (UAS) was advanced into the kidney within the preexisting larger UAS and, using a connecting piece from a Foley catheter, stone fragments were suctioned out through the smaller sheath. Stone-free status was corroborated endoscopically and with postoperative CT. Conclusion: Stone fragments were flushed from the kidney using a simple irrigation technique through a coaxial UAS.
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