The Matryoshka technique in percutaneous nephrolithotomy

Objective: Miniaturized percutaneous nephrolithotomy (PCNL) reduces the risk of haemorrhagic complications, but limited field work represents a drawback. To obtain best outcomes, access size should be intraoperatively tailored. Our purpose is to describe indications and procedural steps Matryoshka technique report its clinical outcomes. Materials methods: We performed retrospective analysis data from consecutive PCNL procedures October 2016 January 2018. Collected included patients’ history, stone characteristics, intra- post-operative items, clearance need for retreatment. The main indication inability securely position guidewire due an obstruction or narrowness in pyelocalyceal system. This begins by puncturing calyx hosting advancing hydrophilic through needle. If cannot proceed beyond stone, employed tract stabilization. carefully dilated with small-bore instruments cautious lithotripsy create enough space introduce under visual control. Once has been stabilized surgeon can upsize optimum complete procedure. Additionally, when intraoperative reassessment induces further dilate quicken Results: Sixteen patients were included, median volume 3.49 cm3. Median operative time was 112 minutes. Three Clavien I-II (postoperative fever) one IIIB (colon perforation) complications reported. No blood transfusions recorded. underwent scheduled retreatment as part multistep Out remaining 13 patients, 10 (76.9%) obtained clearance.Conclusions: helps urologist secure makes flexible progressive, potentially minimizing access-related complications.