TY - JOUR
T1 - Retained Digital Flexible Ureteroscope during Percutaneous Nephrolithotomy
AU - Chen, Tony T.
AU - Metzler, Ian
AU - Sweet, Robert M.
N1 - Publisher Copyright:
© Copyright 2020, Mary Ann Liebert, Inc.
PY - 2020/9
Y1 - 2020/9
N2 - Background: During percutaneous nephrolithotomy, retrograde flexible ureteroscopy can be utilized to facilitate repositioning of stones, enable direct vision percutaneous access, minimize radiation exposure, reduce operating times, and improve stone-free rates. Although advancements in technique and flexible ureteroscope technology for the past decades have rendered complications rare, herein we report a case of a retained ureteroscope during percutaneous nephrolithotomy that was effectively managed endoscopically. Case Presentation: A 59-year-old Caucasian gentleman with a history of recurrent bilateral nephrolithiasis presents for a left-sided percutaneous nephrolithotomy for a large stone burden >4 cm. A ureteral access sheath was used and retrograde ureteroscopy was performed to first reposition several stones into the renal pelvis. During manipulation, we were unexpectedly unable to retract the ureteroscope from the access sheath. We describe procedural details leading up to the event and subsequent intraoperative management using an antegrade approach. Conclusion: A retained flexible ureteroscope is a rare but serious intraoperative complication that may require invasive open surgical management. However, careful endoscopic management may be feasible in select cases, allowing for preservation of ureter and instrument.
AB - Background: During percutaneous nephrolithotomy, retrograde flexible ureteroscopy can be utilized to facilitate repositioning of stones, enable direct vision percutaneous access, minimize radiation exposure, reduce operating times, and improve stone-free rates. Although advancements in technique and flexible ureteroscope technology for the past decades have rendered complications rare, herein we report a case of a retained ureteroscope during percutaneous nephrolithotomy that was effectively managed endoscopically. Case Presentation: A 59-year-old Caucasian gentleman with a history of recurrent bilateral nephrolithiasis presents for a left-sided percutaneous nephrolithotomy for a large stone burden >4 cm. A ureteral access sheath was used and retrograde ureteroscopy was performed to first reposition several stones into the renal pelvis. During manipulation, we were unexpectedly unable to retract the ureteroscope from the access sheath. We describe procedural details leading up to the event and subsequent intraoperative management using an antegrade approach. Conclusion: A retained flexible ureteroscope is a rare but serious intraoperative complication that may require invasive open surgical management. However, careful endoscopic management may be feasible in select cases, allowing for preservation of ureter and instrument.
KW - complication
KW - percutaneous nephrolithotomy
KW - retained ureteroscope
KW - ureteroscopy
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U2 - 10.1089/cren.2020.0010
DO - 10.1089/cren.2020.0010
M3 - Article
AN - SCOPUS:85091993948
SN - 2379-9889
VL - 6
SP - 184
EP - 187
JO - Journal of Endourology Case Reports
JF - Journal of Endourology Case Reports
IS - 3
ER -