Journal of endourology
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Journal of endourology · Oct 2009
ReviewAwake endotracheal intubation and prone patient self-positioning: anesthetic and positioning considerations during percutaneous nephrolithotomy in obese patients.
Obesity is associated with adverse outcomes with certain urologic procedures and may make patient positioning more difficult. We describe our technique of awake intubation and prone patient self-positioning before percutaneous nephrolithotomy (PCNL), and review the literature regarding prone positioning in obese patients and the impact of obesity on PCNL. ⋯ The technique of awake intubation with prone patient self-positioning can be helpful for positioning morbidly obese patients before PCNL and has been safe and effective in properly selected patients. Efficacy of PCNL should not be impacted by obesity or prone positioning and morbidity minimized provided that surgical and anesthesia teams understand and safeguard against potential complications.
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Journal of endourology · Oct 2009
ReviewLaparoscopic techniques for removal of renal and ureteral calculi.
Although most ureteral and renal stones are managed using endourologic techniques or shockwave lithotripsy in daily clinical practice, stone surgery has not completely disappeared. The increasing experience with laparoscopy in urology poses the question of whether urolithiasis may be an indication for laparoscopy. ⋯ Laparoscopic removal of renal and ureteral calculi plays a role in special cases of urolithiasis. In experienced hands, it can be performed safely and efficiently and may therefore replace open stone surgery in most indications.