HOW WE DO PCNL: A STEP BY STEP DEMONSTRATION

The first step we do is RGP followed by injection of air to demonstrate the posterior group of calyces.

THE POSITION WE PREFER IS SIMPLE PRONE WITHOUT ANY KIDNEY BRIDGE 

The desired calyx is marked with tip of the puncture needle and the axis of the puncture is decided.
Then the needle is progressed along the axis of the needle.We use only 0 degree view of the C-Arm and puncture the desired calyx.

We usually put the guide wire in the ureter by manipulating the needle and then use the screw dilator for dilatation.Once the screw dilator is the system ; then we put the guide rod and over that we do single step dilatation with 24 Fr Amplatz dilator followed by 24 Fr Amplatz sheath and use mini nephroscope 15 Fr ( we use either pneumatic or Holmium LASER for stone fragmentation )