Abstract

Objective: To determine safety and efficacy of FOSML position in achieving simultaneous antegrade nephroscopic and retrograde ureteroscopic access in simultaneous management of renal and ureteric stone disease.

Methods: From May 2018 to August 2019, 10 procedures were performed in the FOSML position requiring management of renal stones by supine approach and retrograde uretroscopic lithotripsy for ureteric stones. The indication for these procedures was the presence of renal stone with ipsilateral or contralateral ureteric stone. All procedures were performed using simultaneous anterograde nephroscopic and retrograde ureteric access with the patient under general anesthesia.

Results: All patients underwent preoperative radiological investigation in form of noncontrast CT scan KUB along with anesthesia fitness related investigations. Out of 10 patients, 6 patients underwent supine Percutanous nephrolithotomy (SPCNL) with contralateral ureteroscopic lithotripsy and 4 patients underwent SPCNL with ipsilateral ureteroscopic lithotripsy. All patients underwent DJ stent placement after lithotripy or stone fragment removal and were discharged on second postoperative day.

Conclusion: Antegrade nephroscopic with retrograde ureteroscopic access is safe and effective in FOSML position. It has shorter operative time as both ureteric and renal stones are operated simultaneously and avoids staged approached to management of ureteric and renal stones.

Keywords: Supine Percutaneous Nephrolithotomy; Retrograde Ureteroscpy; FOSML Position; Ureteric Stone

References

1. Goodwin WE., et al. “Percutaneous trocar (needle) nephrostomy in hydronephrosis”. Journal of the American Medical Association 157 (1955): 891-894. 
2. Fernström I and Johansson B. “Percutaneous pyelolithotomy: a new extraction technique”. Scandinavian Journal of Urology and Nephrology 10 (1976): 257-259. 
3. Alken P., et al. “Percutaneous stone manipulation”. The Journal of Urology 125 (1981): 463-466. 
4. Adittya K Sharma and Rahul Yadav. “Supine PCNL in Flank-Free Oblique Supine Modified Lithotomy (FOSML) Position: Our Point of Technique”. Journal of Urology Nephrology 3 (2018): 000139. 
5. Grasso M., et al. “Prone split leg and flank roll positioning: simultaneous antegrade and retrograde access to the upper urinary tract”. Journal of Endourology 7 (1993): 307-310. 
6. Valdivia-Uria JG., et al. “Why percutaneous nephroscopy is still performed with patient prone?” Journal of Endourology 4 (1990): 269-272.
7. Gaspar Ibarluzea., et al. “Supine Valdivia And Modified Lithotomy Position For Simultaneous Anterograde And Retrograde Endourological Access”. BJU International 100 (2007): 233-236. 
8. Moraitis K., et al. “Antegrade/Retrograde Upper Urinary Tract Access: Bart’s Modified Lateral Position for Complex Upper Tract Endourologic Pathologic Features”. Urology (2012). 
9. Rana AM., et al. “Tubeless PCNL with Patient in Supine Position: Procedure for all Seasons?-with Comprehensive Technique”. Urology 71 (2008): 581-585. 

Citation

Citation: Sharma Vikas., et al. “Flank Free Oblique Supine Modified Lithotomy Position (FOSML) for Simultaneous Anterograde and Retrograde Endourological Access. Single Centre Experience". Acta Scientific Medical Sciences 4.3 (2020): 147-149.

Copyright

Copyright: © 2020 Sharma Vikas., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.