How to Perform Supine PCNL in Pediatrics? Is It Different from Adults?
14 Aug 202511:3011:45
Azimjon TursunkulovUzbekistanSpeakerHow to Perform Supine PCNL in Pediatrics? Is It Different from Adults?Percutaneous nephrolithotomy (PCNL) is increasingly favored as a minimally invasive method for treating kidney stones, especially in the supine position, due to its benefits for anesthesia, ergonomics, and overall patient safety. However, when performing supine PCNL in children, urologists encounter distinct challenges that differ significantly from adult patients. In this presentation, we will discuss the key differences and specialized techniques required to successfully and safely perform supine PCNL in pediatric cases.
Important considerations in pediatric patients include their smaller anatomical size, larger stone-to-kidney size ratios, increased sensitivity to fluid overload, and greater vulnerability to radiation exposure. Particular care is needed in patient positioning due to fewer clear anatomical landmarks, making precise ultrasound-guided kidney access crucial to minimize radiation and enhance accuracy. The use of specially designed miniaturized instruments is essential for pediatric procedures, alongside careful management of fluid to prevent complications.
Drawing from extensive personal experience and evidence-based practices, this presentation will cover practical adjustments, such as optimal patient positioning, precise kidney puncture techniques, careful tract dilation, nephroscopic approaches, effective stone removal strategies, and tailored postoperative care. This presentation aims to provide attendees with practical insights and techniques to enhance their approach to supine PCNL in pediatric patients, supporting outcomes comparable to those achieved in adult cases.