Full Description
In recent years the treatment of kidney stones has taken on a new dimension, thanks to modem techniques. E. Schmiedt and Ch. Chaussy revolutionized the therapy of kidney stones with their extra corporeal shockwave lithotripsy. After percutaneous fistulization of the renal cavities by ultrasonically controlled puncture became a rou tine procedure, the obvious next step was to use the same approach, after dilating the track, to carry out intrarenal operations. Dr. Knut Korth has been using this operative technique for some time now. He has gained a great deal of experience, having treated hundreds of patients who have come to him from all parts of Europe. In this book he describes the endoscopic technique which he has used in 400 cases. He does not attempt to compare and contrast his method with others, but rather describes and discusses the route he has taken. The book hence takes on a very subjective character - in the positive sense of the word. Dr. Korth believes - and emphasi zes - that puncture should be performed by the urologist himself so that the final responsibility for an operation is not divided. Our own experience in exclusively urological operations without the help of a radiologist confirm this position. Korth has developed many ideas - some in the form of instru ments - for transcutaneous operations. He describes in detail the various procedures according to the type of stone, providing nume rous examples.
Contents
A. Introduction.- B. Topography of the Percutaneous Track.- C. Position and Preparation of the Patient.- D. Anesthesia.- E. X-Ray Protection.- F. Pyeloscope and Further Percutaneous Instruments.- 1. Pyeloscope.- 2. Instruments for the Kidney Stone Operation.- 3. Instruments for Percutaneous Puncture and Dilatation.- 4. Irrigation and Suction.- G. Puncture of the Kidney.- 1. Puncture of a Dilated Kidney.- 2. Puncture of a Nondilated Kidney.- H. Selection of the Percutaneous Track.- 1. Solitary Pelvic Stones.- 2. Stone in the Upper Ureter.- 3. Pelvic Stones and Calyceal Stones.- 4. Multiple Calyceal Stones.- 5. Staghorn Stones.- J. Dilatation of the Puncture Track.- 1. Normal Anatomic Conditions.- 2. Calyceal Cysts with Small Calyx Necks.- 3. Staghorn Stones and Kidneys with Acute Pyelonephritis.- K. The Percutaneous Operation of Kidney Stones.- 1. Operation in one Session.- 2. Operation Using an Established Track.- 3. Operation of Staghorn Stones.- L. Complications.- M. Contraindications.- N. Further Indications for the Percutaneous Surgical Technique on the Kidney.- 1. Operations of Strictures at the Ureteropelvic Junction.- 2. Percutaneous Resection of Papillary Tumors.- 3. Percutaneous, Intrarenal Marsupialization of Renal Cysts.- O. Appendix: Pyeloscopic Findings.- References.
