A 40 year old gentleman came with staghorn calculus in left kidney.He was taken up for PCNL after due investigation and prophylactic antibiotic therapy.
The staghorn was complete and we had to resort to 5 punctures.
We usually plan the punctures prior and do at the beginning only and place guidewires.We do CT Urography in all staghorn calculi.The Tracts were dilated with Atkins metallic dilators till 30 Fr was broken with pneumatic lithotripsy.The other tracts were subsequently dilated and complete clearance was achieved.We used flexible nephroscopy and Holmium LASER lithotripsy for calculus fragments in the inaccessible calyces.
Thanks for sharing the information the PCNL IN A STAGHORN CALCULUS.
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