The "mini-perc" technique: a less invasive alternative to percutaneous nephrolithotomy

The disadvantages of standard percutaneous nephrolithotomy (PCNL) as compar ed with ureteroscopy or extracorporeal shock-wave lithotripsy include incre ased blood loss, greater pain, and longer hospital stay. A 13-Fr "mini-perc " technique using a ureteroscopy sheath for PCNL was developed in an attemp t to address these drawbacks. Nine "mini-percs" have been performed in pati ents aged 40-73 years with stone burdens of less than or equal to 2 cm(2). On average, patients had 1.4 stones with a cross-sectional area of 1.5 cm(2 ). The mean total procedure time, estimated blood loss, and hematocrit decr ease were 176 min, 83 ml, and 6.6%, respectively. On average, patients used 14 mg of parenteral morphine and stayed 1.7 days in the hospital. There wa s no procedure-related complication or transfusion. Eight of nine kidneys ( 89%) were stone-free on early follow-up at a mean of 3.8 weeks. As compared with standard PCNL, the "mini-perc" technique has similar early success ra tes in selected patients and may offer advantages with respect to hemorrhag e, postoperative pain, and shortened hospital stays.