PCNL (Percutaneous Nephrolithotomy) Operasi Terkini untuk Batu Ginjal

Summary

In this medical procedure, a 41-year-old male patient with a right kidney stone undergoes Percutaneous Nephrolithotomy (PCNL). The stone, which measures 4 cm in length and 2 cm in width, is accessed through a posterior approach. Using ultrasound guidance, the surgeon successfully locates and punctures the kidney, extracting the stone fragments with a pneumatic device. The operation progresses smoothly with minimal bleeding, and the surgeon confirms that the kidney is intact. The stone is broken down and suctioned, with any remaining fragments expected to be expelled naturally. The procedure concludes with a clean surgical site.

Takeaways

• 😀 The procedure being performed is Percutaneous Nephrolithotomy (PCNL) on a 41-year-old male patient with a kidney stone in the right kidney.
• 😀 The stone is described as a 'cetak' stone, which is a specific type of kidney stone.
• 😀 The procedure involves accessing the kidney via the posterior approach, and the stone size is approximately 4 cm in length and 2 cm in width.
• 😀 The first step involves placing a ureteral catheter (UK) and a Cobra catheter to assist with the access.
• 😀 The surgeon uses ultrasound guidance for precision during the procedure.
• 😀 The surgeon locates the stone and accesses the kidney using a needle through the inferior calyx.
• 😀 Once the needle is correctly placed, urine starts to flow, confirming the correct access.
• 😀 After the access is established, the stone is fragmented using a pneumatic lithotripter, which breaks the stone into smaller pieces.
• 😀 The fragments are then removed using ultrasound suction to clear the kidney.
• 😀 The procedure appears successful with no bleeding, and the surgical wound is small with minimal trauma.
• 😀 The surgeon notes that any remaining stone fragments are likely to pass out naturally or may require further treatment.

Q & A

What is the main procedure being described in the transcript?

The procedure being described is a percutaneous nephrolithotomy (PCNL) for a 41-year-old male patient with a kidney stone in the right kidney.

What type of kidney stone is mentioned in the transcript?

The stone is referred to as a 'cetak' stone, which suggests it is a cast or shaped stone in the kidney.

What is the size of the kidney stone?

The kidney stone is approximately 4 cm in length and 2 cm in width.

How is the surgeon accessing the kidney for the procedure?

The surgeon plans to access the kidney posteriorly, using a posterior approach.

What role does ultrasound play in the procedure?

Ultrasound is used for safety and guidance during the procedure to locate the stone and ensure correct needle placement.

What is the significance of the term 'kalik inferior' mentioned in the transcript?

'Kalik inferior' refers to the inferior calyx of the kidney, which is the part of the kidney where the needle is being inserted to access the stone.

How does the surgeon ensure they are in the correct position during the procedure?

The surgeon uses ultrasound to verify the correct position of the needle and ensures the stone is located in the inferior calyx.

What tools or equipment are used during the procedure?

The procedure involves the use of a guide wire (UK), a Cobra catheter, a microscope, and ultrasound for guidance. Additionally, a pneumatic device is used to break the stone into smaller pieces.

What happens to the kidney stone once it is broken into smaller pieces?

The broken pieces of the kidney stone are removed using ultrasound suction, and any remaining fragments are expected to pass naturally or may require further treatment.

What is the final outcome of the procedure according to the transcript?

The procedure is concluded with no significant bleeding, and the stone is expected to be fully cleared, although some minor fragments may remain and exit naturally or be treated later.