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PCNL in Complex Situations: Obese Patients and Spinal Deformities, Ectopic, and Pelvic Kidneys

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Minimally Invasive Percutaneous Nephrolithotomy

Abstract

PCNL is a standard of care for large and complex renal calculi. Although most percutaneous access is safe to make, in some clinical situations, making access can be a huge challenge. The challenge could be related to patient factors like morbid obesity or spinal deformities, or renal factors like un-ascended pelvic ectopic kidney or polycystic kidney disease. Here, the intra-renal or peri-renal anatomy, blood supply, and anatomical relations are altered making the PCNL procedure difficult. PCNL in these situations needs proper assessment and planning. For success and safety of the procedure, additional equipment like flexible scopes, laser, or ECIRS may be needed. Such patients should be treated only by a very experienced endourologist who is backed by a complete gamut of equipment and technology.

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Acknowledgments:

A sincere thanks to Mr. Ramkhilavan Aditya, MSc (PA) for making the figures for this manuscript.

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Authors and Affiliations

  1. Fortis Hospital Mulund, Mumbai, Maharashtra, India

    Pankaj N. Maheshwari

  2. Department of Urology, Grant Government Medical College and Sir JJ Group of Hospitals, Mumbai, Maharashtra, India

    Pankaj N. Maheshwari, Venkat Arjunrao Gite & Mayank Agrawal

  3. Tata Memorial Hospital, Mumbai, Maharashtra, India

    Amandeep M. Arora

Authors
  1. Pankaj N. Maheshwari
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  2. Venkat Arjunrao Gite
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  3. Amandeep M. Arora
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  4. Mayank Agrawal
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Editor information

Editors and Affiliations

  1. Professor and Head, Department of Urology, Global Rainbow Healthcare, Agra, Uttar Pradesh, India

    Madhu S. Agrawal

  2. Head, Department of Urology, Pushpanjali Hospital and Research Center, Agra, Uttar Pradesh, India

    Dilip K. Mishra

  3. Professor and Consultant Urological Surgeon, University Hospital Southampton, Hampshire, UK

    Bhaskar Somani

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Maheshwari, P.N., Gite, V.A., Arora, A.M., Agrawal, M. (2022). PCNL in Complex Situations: Obese Patients and Spinal Deformities, Ectopic, and Pelvic Kidneys. In: Agrawal, M.S., Mishra, D.K., Somani, B. (eds) Minimally Invasive Percutaneous Nephrolithotomy. Springer, Singapore. https://doi.org/10.1007/978-981-16-6001-6_26

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  • DOI: https://doi.org/10.1007/978-981-16-6001-6_26

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-16-6000-9

  • Online ISBN: 978-981-16-6001-6

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