METHOD OF PERCUTANEOUS PUNCTURE APPROACH TO RENAL CAVITARY SYSTEM DURING TREATMENT OF CORAL NEPHROLITHIASIS Russian patent published in 2017 - IPC A61B1/307 A01B1/00 

FIELD: medicine.

SUBSTANCE: under condition of full execution of pelvis and renal calyx by coral calculus, in the absence of dilatation of the cavity elements, an approach is created by performing a puncture "to the calculus". Under combined ultrasound and X-ray-television control, under the conditions of an intimately adjacent mucosa to the calculus, the expansion of the puncture stroke is performed with the help of a dilator with a diametre of not more than 11 W. A rigid endoscope with a diametre of not more than 11 W at one of the installed wires before visualization and correction of the distal tip of the core wire. An endoscopic revision of the distal part of the puncture stroke, the bottom of which is the calculus, is carried out. The end of the core wire is led between the calculus and the mucosa of the calyx. Similar manipulations are performed with the second wire. If there is no possibility to lead the end of the core wire, lithotripsy of the calculus portion adjacent to the endoscope is carried out. In addition, the puncture stroke is treated with a bougie to the required diametre, the mini-nephroscope tube or Amplatz tube is placed with an unbroken end forward.

EFFECT: method provides approach to the renal cavitary system with the installation of core wires under endoscopic control, it is effectively supplemented by lithotripsy, minimizes parenchyma trauma, reduces the risk of bleeding, allows subsequent dilatation and tube installation to remove the calculus completely.

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