Supine Percutaneous Nephrolithotomy - New Tricks to Old Dogs

Year 2020, Volume: 12 Issue: 1, 67 - 77, 30.01.2020

M.can Kiremit , Mustafa Soytaş

Abstract

Percutaneous nephrolithotomy (PNL), the recommended modality in the treatment of large and complex kidney

stones, has undergone various modifications over the years in order to increase stone-free rates and to minimize

complications. One of these modifications was the transition to the supine position, which, among many other

advantages, allowed to perform endoscopic combined intrarenal surgery ergonomically. As with all new surgical

techniques, supine PNL had been questionable for the surgeons at the beginning for the reason of acting out of

ongoing surgical habits. However, due to that the endourologists who had shifted to this technique have proven

its superiorities scientifically, supine PNL has become much more popular during recent times. In this article, we

aimed to discuss the advantages of supine PNL compared to prone position, to present the solutions for the possible

problems related to position, and to clarify some certain misunderstandings about the supine position.

Keywords

Endoscopy combined intrarenal surgery, percutaneous nephrolithotomy, supine position, prone

Supin Perkütan Nefrolitotomi-Eski Köye Yeni Adet

Abstract

Günümüzde büyük ve kompleks böbrek taşlarının tedavisinde önerilen modalite olan perkütan nefrolitotomi (PNL), yıllar içerisinde hem taşsızlık oranlarını arttırmak hem de komplikasyonları minimize etmek için çeşitli modifikasyonlara uğradı. Bu değişimlerden biri, diğer birçok başka avantajının yanında ergonomik bir biçimde endoskopik kombine intrarenal cerrahi yapılabilmesine de olanak sağlaması açısından supin pozisyona geçiş oldu. Her yeni cerrahi teknik gibi supin PNL de başlangıçta cerrahlar tarafından süregelen alışkanlıklarının dışına çıkılması sebebiyle mesafeli karşılansa da geçiş yapan endoürologların üstünlükleri bilimsel olarak ortaya koyması ile son yıllarda giderek artan sayıda taraftar toplamaya başladı. Biz bu makalemizde, supin PNL’nin pron pozisyona kıyasla sahip olduğu avantajları, yaşanabilecek pozisyona bağlı problemlerin çözüm yollarını ve supin pozisyon hakkında doğru bilindiği sanılan yanlışların gerçeklerini anlatmaya çalıştık.

Keywords

Endoskopik kombine intrarenal cerrahi, perkütan nefrolitotomi, supin, pron

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