M. Helal et al., THE HICKMAN PEEL-AWAY SHEATH - ALTERNATIVE FOR PEDIATRIC PERCUTANEOUSNEPHROLITHOTOMY, Journal of endourology, 11(3), 1997, pp. 171-172
Percutaneous nephrolithotomy presents a therapeutic challenge in child
ren because of the disproportion between the sizes of the instruments
and the kidneys, A technique for pediatric nephrolithotomy used on a 2
-year-old female child is presented, The patient was born prematurely
and developed kidney stones as a complication of furosemide therapy, S
he failed medical management with hydrochlorothiazide, and the stone d
id not disintegrate following extracorporeal shockwave lithotripsy (ES
WL). A Chiba needle was used to access the renal collecting system per
cutaneously, Using a guidewire, sequential dilatation was performed to
16F. A 15F Hickman catheter introduction kit was then used, and the s
heath was partially peeled away, A 10F pediatric cystoscope and graspe
r were inserted through the sheath to remove the stones. A 12F cathete
r was then placed through the sheath; the sheath was peeled away, and
the catheter was left indwelling for 48 hours. No complications ensued
, A postoperative nephrostogram showed free drainage and absence of re
sidual stones, Utilization of the Hickman peel-away sheath constitutes
an excellent alternative nephrolithotomy technique for children with
stones unresponsive to more conservative treatment.