Dear Editor,
After percutaneous nephrolithotomy (PCNL), a nephrostomy tube has been routinely placed to ensure hemostasis, provide drainage, and maintain access to the collecting system.
This causes pain after surgery and persistent urine leaks after its removal. Recently, efforts have been expended to either reduce the size of the nephrostomy tube or eliminate it altogether. Hence, tubeless percutaneous nephrolithotomy is now increasingly advocated for the treatment of uncomplicated, large kidney stones [1,2,3]. After surgery, closure of the skin without sealing the nephrostomy tract postoperatively risks bleeding and urinary extravasation [4]. Hemostatic agents have therefore been advocated to seal the PCNL tract. Herein we describe a method to facilitate the accurate application of a Floseal Matrix from the renal parenchyma to skin, and we report the outcomes of tubeless PCNL.
KEYWORDS: Tubeless percutaneous nephrolithotomy, PCNL, Floseal, Floseal Matrix
CORRESPONDENCE: Ho Yee Tiong, MRCS (London), MMed (Surgery), FAMS (Urology), Consultant, Department of Urology, National University Hospital, Singapore ( )
CITATION: UroToday Int J. 2012 December;5(6):art 63.
DOI: http://dx.doi.org/10.3834/uij.1944-5784.2012.12.08
