TY - JOUR T1 - A Novel Technique for Relocating Renal Lower Calyceal Stones During Retrograde Intrarenal Surgery: ‘’Jab and Pull’’ TT - A Novel Technique for Relocating Renal Lower Calyceal Stones During Retrograde Intrarenal Surgery: ‘’Jab and Pull’’ AU - Uslu, Mehmet AU - Ezer, Mehmet AU - Yildirim, Umit AU - Bagcioglu, Murat AU - Sarıca, Kemal PY - 2024 DA - February DO - 10.33719/nju1339275 JF - The New Journal of Urology JO - New J Urol PB - Ali İhsan TAŞÇI WT - DergiPark SN - 3023-6940 SP - 1 EP - 7 VL - 19 IS - 1 LA - en AB - Objective : It is advised to move the stones from the lower calyx to the middle or upper calyx usinga nitinol basket. In order to protect the flexible ureterorenoscopy and increase the stone-free rateduring retrograde intrarenal surgeryIn this descriptive study, we presented a method for moving stones to other calyces where the needfor deflection is less, using holmium fiber in cases where the nitinol basket is not available.Materials and Methods: With the “Jab and Pull” method we have described, 32 patients whounderwent RIRS for symptomatic (pain or infection) renal lower calyceal stones with a diameterof 4-10 mm in our clinic, between 2012 and 2021 were retrospectively analyzed.Demographic data, stone size, Hounsfield unit, number of stones, opaque non-opaque status,stone localization, infundibulopelvic angle, perioperative-postoperative complications, andcontrol imaging were evaluated.Results: The mean age of the patients was 51.12, and the female-male ratio was equal. The medianstone size was 8mm (min:5, max:10), and the Hounsfield unit was 805 (±396.72). 75% (24) ofthe stones were single and 53.1% (17) were opaque. The median infundibulopelvic angle was 38(min:19 max:52) degrees. 27 (84.4%) patients achieved stone-free status using this method. Therenal lower calyx neck of two patients was too narrow, the stones of two patients were too soft, andthe stone of one patient was inaccessible, preventing total success in these patients.Conclusions: In cases where a nitinol basket is needed but cannot be reached during treatmentof kidney lower calyx stones, the “jab and pull” method can be considered as an alternative insuitable patients. KW - kidney stone KW - lower calyx KW - displacement KW - basket catheter N2 - Objective : It is advised to move the stones from the lower calyx to the middle or upper calyx usinga nitinol basket. In order to protect the flexible ureterorenoscopy and increase the stone-free rateduring retrograde intrarenal surgeryIn this descriptive study, we presented a method for moving stones to other calyces where the needfor deflection is less, using holmium fiber in cases where the nitinol basket is not available.Materials and Methods: With the “Jab and Pull” method we have described, 32 patients whounderwent RIRS for symptomatic (pain or infection) renal lower calyceal stones with a diameterof 4-10 mm in our clinic, between 2012 and 2021 were retrospectively analyzed.Demographic data, stone size, Hounsfield unit, number of stones, opaque non-opaque status,stone localization, infundibulopelvic angle, perioperative-postoperative complications, andcontrol imaging were evaluated.Results: The mean age of the patients was 51.12, and the female-male ratio was equal. The medianstone size was 8mm (min:5, max:10), and the Hounsfield unit was 805 (±396.72). 75% (24) ofthe stones were single and 53.1% (17) were opaque. The median infundibulopelvic angle was 38(min:19 max:52) degrees. 27 (84.4%) patients achieved stone-free status using this method. Therenal lower calyx neck of two patients was too narrow, the stones of two patients were too soft, andthe stone of one patient was inaccessible, preventing total success in these patients.Conclusions: In cases where a nitinol basket is needed but cannot be reached during treatmentof kidney lower calyx stones, the “jab and pull” method can be considered as an alternative insuitable patients. CR - 1. Emre Göger Y, Serkan Özkent M, Tansel Kılınç M, Hakkı Taşkapu H, Göger E, Aydın A, et al. Efficiency of retrograde intrarenal surgery in lower pole stones: disposable flexible ureterorenoscope or reusable flexible ureterorenoscope? World J Urol [Internet]. 2021;39:3643-50. 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