Category: Stones: PCNL

VS6-9 - A Novel Technique of Access with 5 mm Laparoscopic Trocar for MiniPercutaneous Nephrolithotomy in Pediatric Patients

Fri, Sep 21
2:00 PM - 4:00 PM

Introduction & Objective : We aimed to highlight results of miniaturized percutaneous nephrolithotomy (miniPCNL) in the treatment of renal stones in pediatric population with a novel technique of access using a 5 mm reusable laparoscopic Aesculap© trocar.


Methods : Medical data of the children diagnosed and underwent miniPCNL due to kidney stone between January 2014 and June 2015 prospectively evaluated. The patients enrolled into two groups: a miniPCNL with Aesculap© laparoscopic trocar (Group 1) and miniPCNL with conventional method (Group 2). Calyceal puncture was carried out using 18gauge needle. Tract dilatation was done with telescopic metal dilatators and access to the collecting system was produced over a 5 mm reusable Aesculap© trocar or 20 F access sheat. Stone fragmentation accomplished with laser lithotripter under the vision of a 10.8 Fr nephroscope without sheat (Group 1) or with a standard 10.8 Fr nephroscope (Group 2). Intraoperative and postoperative parameters compared.


Results : A total of 8 children in group 1 and 4 children in Group 2 were enrolled. There was no significant difference in mean preoperative and postoperative hemoglobin and creatinine drop in both groups (p=0.1). Of the 12 stone, 3 patients (1 in Group 1; 2 in Group 2) were reported to have positive stone culture and these patients developed systemic inflammatory response syndrome (SIRS). Hospital stay was significantly higher in Group 2 (10.5±6.6 vs. 4.1±2.8; p=0.03). Stone free rates were similar for each group (p=0.13) (Table 2).


Conclusions : MiniPCNL using a 5 mm resuable laparoscopic trocar is safe and feasible surgical option for managing renal stones in pediatric population. Further prospective controller trials are needed to confirm the feasibility of this technique.

Yiloren Tanidir

Director of Endourology and Stone disease
Marmara University, Department of Urology, Istanbul, Turkey
Istanbul, Istanbul, Turkey

Dr. Tanidir obtained his medical degree from Hacettepe University in Ankara, Turkey in 2001. He completed his urology residency at Marmara University School of Medicine in Istanbul, Turkey between 2002-2007.

Dr. Tanidir joined the faculty of Marmara University School of Medicine in 2014. Initially, he served as a Lecturer and Urology Specialist in the Urology Department. In 2015, he promoted to Assistant Professor of Urology and finally in April 2018, he became an Associate Professor of Urology. He is an expert in endoscopic surgery of urinary tract stone disease. He is both involved in the medical and surgical management of patients, education of urology residents and medical students. He is the primary investigator of many on-going scientific research projects.

His main primary research areas are endourological interventions, urinary tract stone disease, and metabolic stone disease. His secondary research areas are reconstructive urology, pediatric urology, functional urology, and urooncology. He serves as a member on the Patient Information Group of European Urology Association (EAU) since 2016. He is in the editorial board of Uropedia since 2016 and recently became a board member in The Society of Minimal Invasive Urology in Turkey.

Dr. Tanidir has published research, covering a broad range of topics in urology, in numerous formats, including book sections and articles in peer-reviewed journals. He also has been invited as a speaker to various congress and meetings.

Asgar Garayev

assistant professor
Istanbul Bilim University
Istanbul, Istanbul, Turkey

Mehmet Kazim Asutay

MD
Marmara University, Department of Urology, Istanbul, Turkey
İstanbul, Istanbul, Turkey

Cagri Akin Sekerci

MD
Marmara University, Department of Urology, Istanbul, Turkey
Istanbul, Istanbul, Turkey

Cem Akbal

Prof.
Department of Urology, Marmara University, Istanbul, Turkey
İstanbul, Istanbul, Turkey

Ferruh Simsek

Prof.
Marmara University, Department of Urology, Istanbul, Turkey
Istanbul, Istanbul, Turkey