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Editorial comment to “ Percutaneous endoscopic nephropexy with a percutaneous suture passed through the kidney ”

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I believe the article “Percutaneous endoscopic nephropexy with a percutaneous suture passed through the kidney” is a new and stunningly simple point of technique... Whereas for a century open nephropexy was performed suturing the kidney to the posterior ipsilateral abdominal wall, over the last decades laparoscopical and percutaneous techniques have been applied in a minimally invasive fashion... This would therefore require fixation together with the kidney... Most of the previous open surgical techniques and most of the minimally invasive techniques have been performed by a retroperitoneal approach which may explain the poor results (poor symptomatic improvement) in the past as this pathognomonic mechanism was not revealed... In this article, the authors present a technique where the kidney is fixed with an absorbable suture (2-polyglactin – Vicryl)... However, from our own experience of inferior mobilisation of the kidney with a thorough-and-thorough guidewire through the lower calyx for upper pole puncture during PCNL we may say that even with a much more solid guidewire no slicing of the kidney occurs... It remains to be seen however whether the intra-calyceal part of the suture can lead to stone formation... The mean operative time was only 33 min which is shorter than any of the other methods... I believe that this procedure could be performed as a day case or short-stay procedure... There is no doubt that this alternative technique is easy, probably safe, less time consuming and therefore cost-effective... Clinical application will establish its long-term efficacy.

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Editorial comment to “ Percutaneous endoscopic nephropexy with a percutaneous suture passed through the kidney ”
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4442927&req=5

View Article: PubMed Central

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

I believe the article “Percutaneous endoscopic nephropexy with a percutaneous suture passed through the kidney” is a new and stunningly simple point of technique... Whereas for a century open nephropexy was performed suturing the kidney to the posterior ipsilateral abdominal wall, over the last decades laparoscopical and percutaneous techniques have been applied in a minimally invasive fashion... This would therefore require fixation together with the kidney... Most of the previous open surgical techniques and most of the minimally invasive techniques have been performed by a retroperitoneal approach which may explain the poor results (poor symptomatic improvement) in the past as this pathognomonic mechanism was not revealed... In this article, the authors present a technique where the kidney is fixed with an absorbable suture (2-polyglactin – Vicryl)... However, from our own experience of inferior mobilisation of the kidney with a thorough-and-thorough guidewire through the lower calyx for upper pole puncture during PCNL we may say that even with a much more solid guidewire no slicing of the kidney occurs... It remains to be seen however whether the intra-calyceal part of the suture can lead to stone formation... The mean operative time was only 33 min which is shorter than any of the other methods... I believe that this procedure could be performed as a day case or short-stay procedure... There is no doubt that this alternative technique is easy, probably safe, less time consuming and therefore cost-effective... Clinical application will establish its long-term efficacy.

No MeSH data available.