53yo, DM (A1c:6.0), HTN
3cm R UVJ, L 1.7cm lower pole, 1578 HU, SSD 10.5cm
UCx negative.
Pre-op diangosis
1. Left Renal calculus <2cm
2. Hx of R hydronephrosis
3. bilateral flank pain
Procedures performed:
1. Left Percutaneous ultrasonic nephrolithotripsy approximatley 2cm, tubeless
2. Dilation and establishemt of a percutaneous access tract
3. Antegrade placement of firm double-J uretral stent
4. Antegrade nephrostogram
5. Fluroscopy <1hr
6. Images interpreted by MD
7. Placmeent of of Foley by MD
Items needed:
1. 16F Foley
2. Omnipaque contrast
3. Sensor wire
4. Super stiff wire
5. dual lumen catheter
6. 11 blade
7. Curved hemostat
8. Nephrostomy dilation balloon 30F
9. nephroscope (non-obese) (ensure clear lens)
10. Lithotriptor
10. Lithotripter probe (on and working)
11. Laser
12. Laser fiber 270 (setting of 1.4J x 6Hz for fragment, 0.3J x 70Hz for dusting) given dense stone
13. Cystoscopse
14. 5Fr open ended catheter
15. Cook 6F x 24cm firm double J stent
16. Additional 20F foley catheter
17. Kaye nephrostomy tampnoade balloon