youtu.be/3l-zXhJnlf8?si… My initial puncture in PCNL.

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It was great time to have senior consultant pediatric Urologist dr Naser A N S S Alanazi from Kuwait and Senior Consultant Urologist Dr Kassim Abdalla from Kenya at our Khadgi Institute of Endourology.

Mini PCNL on 8/M, multiple stones. Surpa 11 lateral pucture through upper pole,20fr dilatation. Mid calyceal stone,saline pushed technique, complete clearance with single tract in 30 min duration.

Beauty of Mini PCNL. Immediate stone clearance on table,flouro and endoscopic confirmation. 30/M left solitary kidney, 2.5cm stone in lower calyx,16 fr dilatation through lower calyx,duration 15 mins skin to skin.

When the initial puncture is through the fornix of the calyx then no fear of bleeding. Precise puncture is utmost important in MPCNL/PCNL.

Amazing resolution of chinese scope.

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Just to demostrate,more medial puncture more vertical tract and more lateral puncture more horizontal tract which plays important role in stone evacutation by vaccume cleaner effect. When we can achieve horizontal access then suction device is not required.

1/f left PUJ stone 12 mm underwent MPCNL 16fr,complete stone clearance. Some contrast extravasation noted during RPG, however went uneventful.

1/f, left PUJ stone of 12 mm underwent Left MPCNL, contrast extravasation noted during RPG ,however complete stone clearance with DJ stenting.

"Very Challenging" 12 mm upper ureteric stone,planned MPCNL but contrast extravasated from PCS and only lower pole seen faintly and middle /UP not seen. So IP through lower pole n injected contrast to opacify MP n UP then 2nd puncture performed through MC.

What a satisfying to perform staghorn stone by Mini PCNL ,one tract, local pneumatic lithoclast,complete clearance in 30 mins duration.

72/f, Rt lower pole 17 mm stone with retrorenal colon (lower pole), H/o Rt pyelolithotomy 10 yrs ago. Rt. supra 11 lateral puncture through mid calyx,18 fr dilatation.

"Saline push technique" Credit goes to S.K Pal sir.

Great time in Coimbatore,India. 6 tracts to complete staghorn stone in one session, tubeless Mini PCNL.

Series of complete staghorn stones. Tubeless Mini PCNL,Complete clearance with two tracts. Mid calyceal 16 fr and lower posterior 20 fr.

25/F with left renal stones BMI 44.4 planned left MPCNL under S/A. Really difficult to keep in proper position. However, uneventful procedure.

Interesting case of Lt. UUstone 10mm,pelvis stone of 25mm and upper pole stone of 15 mm,approach upper pole oblique tract , saline push tech.with complete clearance.