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Renal stones  endoscopic  management         Dr sarwar noori mahmood F.I.C.MS(urology), F.E.B.U
Indications for treatment ,[object Object],[object Object]
Treatment of Renal Stones ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Natural history of renal stones
 
Spontaneous clearance of stones takes place  ONLY WHEN— 1.There is good flow of urine/function on the affected side & 2.There is no distal obstruction
MANAGEMENT OF RENAL CALCULI by ESWL ,[object Object],[object Object],[object Object],[object Object],[object Object]
Treatment of Renal Stones
ESWL
Generation of shock wave
T H E  M A G I C  W O R D---  LITHOTRIPSY EXTRA CORPOREAL SHOCK WAVE  LITHOTRIPSY WHAT  ARE  SHOCK  WAVES?
 
 
There should be a limited amount of gravel , which is expected to be passed out spontaneously within  reasonable time limit , without causing much discomfort/colics .
IDEAL  SITUATION  FOR  SUCCESSFUL  E.S.W.L.  Renal  calculus of less than 2 cm having hetrogenous calcification/ architecture  In X- ray , in a well functioning renal unit with no distal obstruction
 
 
 
Percutaneous nephrolithomy PCNL  The key-hole surgery
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FUCTIONAL ANATOMY OF KIDNEY FOR  PERCUTANEOUS TECHNIQUE   1.              VASCULAR    2.              CALYCEAL   3.              ANATOMIC RELATION   
 
PERCUTANEOUS RENAL SURGERY   PRE – OP WORK UP   Urine culture Renal function test Haematological profile Caogulation profile KUB and IVU US .                                
Steps for PCNL ,[object Object],[object Object],[object Object],[object Object],[object Object]
ANAESTHESIA ,[object Object],[object Object],[object Object]
Body position ,[object Object],[object Object],[object Object]
 
Retrograde ureteric catheterization ,[object Object],[object Object],[object Object]
 
[object Object],[object Object],[object Object]
 
 
 
 
[object Object],[object Object],Which one is better ? 2 methods combination better.why?
 
 
 
 
 
 
 
 
 
 
 
 
 
[object Object],[object Object],[object Object],[object Object]
Double-J stent and nephrostomy tube placement,Tubeless PCNL NOT common
 
 
PERCUTANEOUS RENAL SURGERY COMPLICATIONS     1.                          RENAL PELVIC PERFORATION   2.                          HAEMORRHAGE   3.                          INJURY ADJACENT ORGANS   4.                          UROSEPSIS   5.                          FLUID ABSORPTION    6.                          AV  MALFORMATION    
 
Ureteric stone
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF URETERIC STONES ,[object Object],[object Object],[object Object],[object Object]
MANAGEMENT OF URETERIC STONES ,[object Object],[object Object],[object Object],[object Object]
RESULTS OF URETROSCOPIC LITHOTRIPSY (URS) ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
[object Object],[object Object]
RENAL STONES
Nephrolithotomy
PREVENTION OF STONES ,[object Object],[object Object],[object Object]
DIETARY ADVICE ,[object Object],[object Object],[object Object],[object Object],[object Object]
MEDICATIONS ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Surgery 6th year, Tutorial (Dr. Sarwar Noori)

  • 1. Renal stones endoscopic management Dr sarwar noori mahmood F.I.C.MS(urology), F.E.B.U
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  • 4. Natural history of renal stones
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  • 6. Spontaneous clearance of stones takes place ONLY WHEN— 1.There is good flow of urine/function on the affected side & 2.There is no distal obstruction
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  • 11. T H E M A G I C W O R D--- LITHOTRIPSY EXTRA CORPOREAL SHOCK WAVE LITHOTRIPSY WHAT ARE SHOCK WAVES?
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  • 14. There should be a limited amount of gravel , which is expected to be passed out spontaneously within reasonable time limit , without causing much discomfort/colics .
  • 15. IDEAL SITUATION FOR SUCCESSFUL E.S.W.L. Renal calculus of less than 2 cm having hetrogenous calcification/ architecture In X- ray , in a well functioning renal unit with no distal obstruction
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  • 19. Percutaneous nephrolithomy PCNL The key-hole surgery
  • 20.
  • 21. FUCTIONAL ANATOMY OF KIDNEY FOR PERCUTANEOUS TECHNIQUE   1.              VASCULAR   2.              CALYCEAL   3.              ANATOMIC RELATION  
  • 22.  
  • 23. PERCUTANEOUS RENAL SURGERY   PRE – OP WORK UP   Urine culture Renal function test Haematological profile Caogulation profile KUB and IVU US .                               
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  • 50. Double-J stent and nephrostomy tube placement,Tubeless PCNL NOT common
  • 51.  
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  • 53. PERCUTANEOUS RENAL SURGERY COMPLICATIONS     1.                         RENAL PELVIC PERFORATION   2.                         HAEMORRHAGE   3.                         INJURY ADJACENT ORGANS   4.                         UROSEPSIS   5.                         FLUID ABSORPTION   6.                         AV MALFORMATION    
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