Simultaneous bilateral endoscopic surgery (SBES) is the performance of a percutaneous nephrolithotomy (PCNL) on one side and a retrograde intrarenal surgery (RIRS) on the other kidney simultaneously.
Our aim is to report through a video the surgical technique and the step-by-step details of a SBES performed in a pediatric patient.
Patients and methods
A 12-year-old male patient with bilateral upper tract urolithiasis.
Supine PCNL is performed in Galdakao-modified Valdivia position. Ureteroscopic surgeon performs retrograde pyelography on PCNL kidney. Percutaneous access under fluoroscopic guidance trough the lower calyx and dilated with Amplatz dilators to 17.5 Fr. Storz® 17.5 MIP Nephroscope is introduced and fragmentation with pneumatic lithotripter starts. On the other kidney, after introduction of ureteral sheet 12/14 Fr and digital flexible ureteroscope Flex Xc ® 9.5Fr, pulverization of the stone starts with Laser Holmium YAG (Oddysey®). Surgeons work simultaneously and share fluoro-scopic c-arm.
SBES can be reproduced in children. Proper planification and preparation of the involved team and OR set up are essential. Further prospective randomized studies are needed to establish safety and efficacy of SBES in pediatric patients.
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- Simultaneous bilateral endoscopic surgery for patients with bilateral upper tract urolithiasis: technique and outcomes.Eur Urol. 2018; 74: 810-815https://doi.org/10.1016/j.eururo.2018.06.034
- Simultaneous bilateral endoscopic surgery (SBES) for bilateral urolithiasis: the future? Evidence from a systematic review.Curr Urol Rep. 2019; 20
- Simultaneous bilateral endoscopic manipulation for bilateral renal stones.Urology. 2016; 94: 265-269
Published online: December 04, 2020
Accepted: November 28, 2020
Received: May 29, 2020
© 2020 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.