Percutaneous Renal Surgery by David R Webb

Author:David R Webb
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

A useful aid for determining the direction of the renal pelvis is the retrograde infusion of methylene blue solution.

A pre-prepared solution of normal saline and methylene blue is infused through the retrograde catheter by the assistant.

Fig. 6.19Identification of the direction to the renal pelvis using RG injection of a saline and methylene blue solution

The surgeon is directed by the blue flushes to the space between the stone and calyceal wall, which indicates the direction in which to pass the guide wire through the nephroscope, or further excavate with the sonotrode. As the stone bulk is reduced, the methylene blue infusion becomes more profuse and the path for the guide wire clearer.

As soon as the surgeon reaches the renal pelvis, a UGW should be established.

Fig. 6.20Establishment of UGW

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