5 fr open ended ureteral catheter

All cases of mini PCNL were done by a single surgeon (SYC). Under general anesthesia, patients were placed in the Barts “flank-free” modified supine position [14 (link)]. We inserted a 5-Fr open-ended ureteral catheter (Cook Medical, Bloomington, IN, USA) into the renal pelvis using cystoscope and evaluated the calyceal system with contrast dye. The bladder was drained with a 12-Fr urethral Foley catheter, which was attached to the ureteral catheter. An 18-G echo-tip Chiba needle was inserted into the midpole or lower-pole calyx under ultrasonographic and fluoroscopic guidance. A 0.035-inch stiff type ZIPwire™ (Boston Scientific, Marlborough, MA, USA) was then inserted into the renal collecting system or down the ureter through the needle sheath under fluoroscopic guidance. The skin and fascia were incised, and the tract was dilated with a fascia dilator in a stepwise manner. Then, a matched metallic sheath was inserted. A size 12-Fr nephroscope (Karl Storz, Tuttlingen, Germany) was inserted through a 15/16.5-Fr metallic sheath. At the end of the procedure, we used a hemostatic agent without a nephrostomy tube.

As RIRS, mPCNL also was conducted in the same way by all surgeons in this study. Patients were positioned in the Barts “flank-free” modified supine position under general anesthesia [15 (link)]. With the aid of a cystoscope, we placed a 5-Fr open-ended ureteral catheter (Cook Medical, Bloomington, IN, USA) into the renal pelvis and used contrast dye to examine the calyceal system. A 12-Fr urethral Foley catheter, which was attached to the ureteral catheter, was used to drain the bladder. Under the assistance of ultrasound and fluoroscopy, an 18-G echo-tip Chiba needle was typically introduced into the mid-pole or lower-pole calyx. A 0.035-inch stiff type ZIPwire™ (Boston Scientific, Marlborough, MA, USA) was then inserted into the renal collecting system or down the ureter through the needle sheath under fluoroscopic guidance. A fascia dilator was used to gradually widen the tract after the skin and fascia were incised. Then, a matched metallic sheath was inserted. A size 12-Fr nephroscope (Karl Storz, Tuttlingen, Germany) was inserted through a 15/16.5-Fr metallic sheath. At the end of the procedure, we used a hemostatic agent without a nephrostomy tube. We used the same automated irrigation pump in mPCNL, the FloSteady Irrigation Pump (Stryker, Kalamazoo, MI, USA), for stable flow. The maximal pressure setting was 50 mmHg 1.0 L/min for the mPCNL.