Percutaneous ultrasonic lithotripsy. A success rate of 95 to 98 per cent should be achievable.
Percutaneous ultrasonic lithotripsy. Applications of thesemethods toupperureteral stones hasresulted inover 86%success. However, except for open and laparoscopic surgery, PCNL is the most invasive of the PCNL is a method of crushing and removal of stones in the pyelonephrine or upper ureteral segment by percutaneous renal channels combined with pneumatic ballistic, holmium laser, or ultrasonic lithotripsy equipment. Greatly reduced patient morbidity and disability are the primary advantages of this technique. Many lithotripsy energy sources were first used for lithalopaxy, the crushing of bladder stones. Percutaneous ultrasonic lithotripsy, whencombined with adjuncts suchasflexible nephroscopy, radiologic stonema- nipulation, andstricture dilatation, isaneffective treatment forcalculi. Radiologic involvement in calculus evaluation, percutaneous nephrostomy placement, track dilatation, and stone removal has contributed to development and application Percutaneous ultrasonic lithotripsy is a widely available technique providing controlled calculus disintegration and removal. This study aimed to analyze the differences in the effects of flexible ureteroscopic holmium laser lithotripsy and percutaneous nephrolithotomy for the treatment of kidney stones, as a way to explore the best treatment plan. Feb 1, 2017 · Patient summary We found no significant differences in the success rate and complications of percutaneous nephrolitotomy using pneumatic and ultrasonic lithotripsy. The advantages of PUL are its lower morbidity and a much shorter convalescence following Study with Quizlet and memorize flashcards containing terms like A cystoscope is an instrument used for examination of the __________. Percutaneous ultrasonic lithotripsy, endoscopically guided removal of fragments through … Comparing ureteroscopy, shockwave lithotripsy, and percutaneous nephrolithotripsy Understanding what is the best option for treating your kidney stone can be difficult. The doctor then puts a hollow tube into your kidney and a probe through the tube. Significant quantitative absorption of glycine into blood and Nov 11, 2023 · “Intracorporeal lithotripsy” literally means “fragmentation of stones occurring within the body”. A form of lithotripsy is then used to fragment the stone. To evaluate the balance between existing evidence and expert opinions on the safety and efficacy of new technological improvements in lithotripsy techniques for percutaneous nephrolithotomy (PCNL). This article presents a case of Interventional Radiology-operated cholecystoscopy using ultrasonic lithotripsy and stone basket retrieval with an emphasis on the equipment, technique, and peri-procedural management essential to the procedure, as well as a review of the literature. Despite the challenges posed by the unique anatomy and clinical features of kidney transplant recipients, we demonstrate the safety and efficacy of percutaneous nephrolithotomy with pneumatic and ultrasonic Ultrasound Lithotripsy William P. The nurse is receiving in transfer from the postanesthesia care unit a client who has had percutaneous ultrasonic lithotripsy for calculuses in the renal pelvis. nephropathy Suffix and its meaning: Combining form and its meaning: Medical word definition: 3. Break the medical word into its word parts and give the meaning of each word part. To compare the clinical outcomes of lithotripsy using the 100 W Ho:YAG laser and the Trilogy lithotripter in Mini-percutaneous nephrolithotomy (PCNL), and to determine the most effective method for stone clearance through a miniaturized percutaneous tract. Pneumatic lithotripsy (Lithoclast®) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris May 1, 1984 · Ultrasonic lithotripsy employed with a percutaneous nephroscope is a safe, controlled method of removal of renal and ureteral stones using the techniques described herein. Percutaneous ultrasonic lithotripsy, endoscopically guided removal of fragments through a percutaneous track, is becoming a widely used method for removal of symptomatic renal and lithotripsy A method of fragmenting stones in the urinary system and in the gall bladder, by focused and concentrated ultrasonic shock waves. As novel methods of lithotripsy enter Percutaneous ultrasonic lithotripsy has become a primary therapeutic modality for safe and rapid removal of symptomatic renal calculi. Percutaneous ultrasonic lithotripsy, endoscopically guided removal of fragments through a percutaneous track, is becoming a widely used method for removal of symptomatic renal and Study with Quizlet and memorize flashcards containing terms like The nurse is receiving in transfer from the postanesthesia care unit a client who has had a percutaneous ultrasonic lithotripsy for calculuses in the renal pelvis. BACKGROUND Present ultrasonic stone removal methods evolved from the development of two factors. Lithotripsy treats kidney stones by sending focused ultrasonic energy or shock waves directly to the stone first located with fluoroscopy (a type of X-ray “movie”) or pelvic ultrasound (high frequency sound waves). A total of 227 consecutive percutaneous n. com The patient subsequently underwent serial catheter exchanges and 5 attempts at percutaneous stone extraction by interventional radiology; however, a large stone burden remained. Complications of percutaneous ultrasonic lithotripsy appeared equitable with those of surgical lithotomy. lithotripsy (as in percutaneous ultrasonic lithotripsy) Suffix and its meaning: View full document Lithotripsy What is lithotripsy? Lithotripsy is a procedure used to treat kidney stones that are too large to pass through the urinary tract. Lithotripsy treats kidney stones by sending focused ultrasonic energy or shock waves directly to the stone first located with fluoroscopy (a type of x-ray “movie”) or ultrasound (high frequency sound waves). It involves the use of piezoelectric crystals to generate ultrasound waves that are transmitted through a probe to break the stones into smaller fragments for extraction. Percutaneous nephrolithotomy and flexible ureteroscopic holmium laser lithotripsy are common lithotripsy procedures. This article reviews the establishment of percutaneous renal access, track dilatation, and stone removal methods that constitute this technique. Materials and Methods. [3] which may be done non-invasively. Suprapubic tube B. Ultrasonic lithotripsy is defined as a procedure that uses high-frequency sound waves to break down kidney stones. 5 per cent glycine solution … May 16, 2016 · One recently developed treatment is percutaneous ultrasonic lithotripsy, which consists of passing a rigid tube (nephroscope) through a small skin incision into the kidney. The patients' gallstones were successfully removed via percutaneous ultrasonic lithotripsy during a collaborative procedure with interventional radiology and urology. Of the patients who underwent percutaneous ultrasonic lithotripsy 6 (6 per cent) required extended hospital days or additional procedures for management of complications. Given the difficulty in fracturing his stone with electrohydraulic lithotripsy, urology was consulted for attempted ultrasonic lithotripsy. 1. lithotripsy (as in percutaneous ultrasonic lithotripsy) Suffix and its meaning: -tripsy (crushing) Combining form and its meaning: lith/o (stone) Medical word definition Feb 29, 2020 · Intracorporeal lithotripsy has become the most common method for stone removal and evacuation during percutaneous nephrolithotomy (PCNL). Percutaneous stone surgery is usually used for larger stones. In this study, we aimed to compare the success rates of pneumatic and ultrasonic lithotripsy techniques during PNL. Learn more here. Dec 1, 1986 · Percutaneous ultrasonic lithotripsy (PUL) is essentially harmless to the renal tissues and is effective at stone fragmentation and simultaneous removal;" but it may be relatively slow to break up hard stones (Fig. Cystogram What is an intrument used to measure the specific gravity of urine Urinometer A percutaneous ultrasonic lithotripsy is performed to Crush kidney stones For what does the urinary bladder serves as a reservoir Urine Objective: Shock wave lithotripsy (SWL) is an attractive initial treatment for nephrolithiasis. We investigated the efficacy and safety of PCNL via Lithoclast® alone or combined with ultrasonic lithotripsy. Percutaneous ultrasonic lithotripsy, endoscopically guided removal of fragments through a percutaneous track, is becoming a widely used method for removal of symptomatic renal and Dec 15, 2024 · 1. Ultrasonic lithotripsy is defined as a medical procedure that utilizes ultrasonic waves to achieve controlled destruction of stones, allowing for the quick removal of resulting fragments under endoscopic control. Radiologic involvement in calculus evaluation, percutaneous nephrostomy placement, track dilatation, and stone removal has contributed to development and application Jun 1, 1984 · Percutaneous ultrasonic lithotripsy has become a primary therapeutic modality for safe and rapid removal of symptomatic renal calculi. , In the term excretory, the root excretor means __________. In this procedure, an ultrasonic probe inserted through a nephrostomy tube into the renal pelvis generates ultra-high-frequency sound waves to shatter renal calculi. High-performance ultrasonic lithotripsy for fast stone clearance shortens operating time. Lithotripsy lets people with certain types of kidney stones not need surgery. This quasi-experimental study was conducted in the Urology Department of the National Institute of Kidney Diseases and Urology (NIKDU) in Dhaka, Bangladesh from April 2019 to March 2020. 2). 5 per cent glycine solution tagged with 14 carbon-glycine. 6 Ho: YAG laser which mostly applied in stone PCNL is a method of crushing and removal of stones in the pyelonephrine or upper ureteral segment by percutaneous renal channels combined with pneumatic ballistic, holmium laser, or ultrasonic lithotripsy equipment. None of these patients required a surgical incision. lithotripsy (as in percutaneous ultrasonic Kidney Stones Researchers in the Department of Urology are investigating all facets of kidney stones, including why they form, how they damage the kidneys and potential new treatment options to add to the existing options of extracorporeal shock wave lithotripsy (ESWL), ureteroscopy with laser fragmentation of stones, and percutaneous nephrolithotomy. A total of 227 consecutive percutaneous n Dec 15, 2023 · Background: Ultrasonic and pneumatic lithotripters are the gold standard for percutaneous nephrolithotripsy. A total of 227 consecutive percutaneous nephrolithotomy procedures for renal calculi were performed. Then give the definition of the medical word. Unfortunately, a significant number of stones are resistant to SWL therapy and require subsequent percutaneous ultrasonic lithotripsy (PUL) for definitive treatment. It was first popularized by Aiken (1), Marberger (2), Wickham (3) and Segura (4) about 5 or 6 years ago and is now a well established procedure in most of the major urological centres. ureteroplasty Suffix and its meaning: Combining form and its meaning: Medical word definition: 2. , The sudden need to void, or urinate, is called __________. It works by sending focused ultrasound energy as shock waves directly to the stone. Sep 13, 2023 · Their large gallstones remained refractory to attempts at removal by electrohydraulic lithotripsy via the cholecystostomy access. Mar 15, 2024 · Percutaneous nephrolithotomy and shock wave lithotripsy are two popular treatment options for kidney stones. Percutaneous ultrasonic lithotripsy (PUL), based on access to the kidney via a percutaneous nephrostomy track, consists of fragmentation and removal of calculi under visual nephroscopic control. [5 – 7] Ultrasonic lithotriptors, first described for fragmentation of bladder stones, [8] transmit acoustic wave energy along a probe that is converted at the probe tip to A collaborative treatment can help patients with inoperable gallstones get relief from pain and a life of tubes. Radiologic involvement in calculus evaluation, percutaneous nephrostomy placement, track dilatation, and stone removal has contributed to development and application Their large gallstones remained refractory to attempts at removal by electrohydraulic lithotripsy via the cholecystostomy access. Through advanced technologies, more efficient fragmentation has become possible, allowing for a variety of treatment options depending on stone location, size, and composition. Percutaneous nephrolithotomy (PNL) is the procedure of choice for large renal stones. To compare the effectiveness and safety of ultrasonic and pneumatic lithotripters in the treatment of renal stone disease. A scoping review approach was applied to search Apr 18, 2020 · This was the first example of Percutaneous Nephrolithotomy (PCNL). Jul 25, 2025 · Extracorporeal Shock Wave Lithotripsy (ESWL) Extracorporeal (ek-struh-kor-PORE-ee-uhl) Shock Wave Lithotripsy (ESWL) is a non-invasive procedure to get rid of kidney stones. AI generated definition based on: Percutaneous Surgery of the Upper Urinary Tract, 2016 Percutaneous removal of upper urinary tract calculi is a well established procedure. Abstract Since its initial introduction in 1976, percutaneous nephrolithotomy (PCNL) has been widely performed for the management of large renal stones and currently is recommended for staghorn calculi, kidney stones larger than 2 cm, and shock wave lithotripsy-resistant lower pole stones greater than 1 cm. Jan 1, 2012 · The terms lithotrite and lithotripsy derive from the Greek lithos for “stone” and the Latin tritus, a derivation of terre, meaning “to rub” [1]. Percutaneous nephrolithotomy (PCNL) refers to the technique of removing renal stones Abstract Percutaneous ultrasonic lithotripsy, endoscopically guided calculus fragmentation and removal through a percutaneous track, is the most widely used technique in the United States for removal of symptomatic upper urinary tract calculi. , A percutaneous ultrasonic lithotripsy is performed to __________. Shockwave lithotripsy (SWL) and ureteroscopy (URS), perfected over the past decades, together with PCNL, make up the three main surgeries used for stone removal. With a rabbit model this complication is recreated with the intraperitoneal instillation of 1. PERCUTANEOUS LITHOTRIPSY MECHANISMS In this section, we discuss the basic mechanisms of pneumatic and ultrasonic lithotripsy, with additional focus on historical and currently used single-energy devices. Percutaneous ultrasonic lithotripsy of upper urinary tract lithiasis is successfully applied to completely remove symptomatic renal calculi in two children with idiopathic hypercalciuria. A hollow steel tube passed through the nephroscope carries ultrasonic energy, which gradually fragments the stone when the tube is brought into contact with it. Nov 23, 2012 · Percutaneous removal of upper urinary tract calculi is a well established procedure. The goal of this chapter is to help the reader become more familiar with the newer Ultrasound lithotripsy for mini-perc and ureter. Clinical experience has proven this modality to be safe, reliable, and effective for treatment of symptomatic Percutaneous ultrasonic lithotripsy has become a primary therapeutic modality for safe and rapid removal of symptomatic renal calculi. This article compares the two procedures, discussing their advantages, disadvantages, success rates, recovery time, and potential complications. Abstract Percutaneous renal calculus removal has evolved rapidly over the past 4 years. May 1, 1984 · Ultrasonic lithotripsy employed with a percutaneous nephroscope is a safe, controlled method of removal of renal and ureteral stones using the techniques described herein. Nov 15, 2020 · Lithotripsy is a noninvasive procedure that treats kidney stones that are too large to pass through the urinary tract. There is a variety of modalities for stone fragmentation including ultrasonic, electrohydraulic, pneumatic lithotripsy (PL) or laser lithotripsy (LL). PCNL has virtually replaced open surgery because it allows removal of even large stones. The goal of this chapter is to help the reader become more familiar with the newer lithotripters and to critically select the best available lithotripsy device for each situation. The patients’ gallstones were successfully removed via percutaneous ultrasonic lithotripsy during a collaborative procedure with interventional radiology and urology. Mulvaney was the first person who attempted to disintegrate stones through “ultrasonic vibrations”, in 1953. Percutaneous nephrolithotomy is the treatment of choice for large renal stones. Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Learn how percutaneous cholangioscopy and dual modality lithotripsy offers relief. The doctor makes a small incision in your back. As novel methods of 6. Electrohydraulic lithotripsy (EHL), pneumatic lithotripsy (PL), and ultrasonic lithotripsy (USL) for the treatment of ureteral stones also Percutaneous ultrasonic lithotripsy (PUL): kidney stone disintegrationMeSH terms Catheterization Dilatation Humans Kidney Calculi / therapy* Ultrasonic Therapy / instrumentation Ultrasonic Therapy / methods* Ureteral Calculi / therapy* Urography Keynote message. High energy ultrasound waves, generated by a high-voltage spark discharge, can be focused to a point by parabolic reflectors and aimed so that the point of focus coincides with the stone. Abstract Percutaneous nephrolithotomy is the treatment of choice for large renal stones. This technique transforms electric energy into ultrasonic energy, which is transmitted through a piezoelectric crystal to fragment stones while minimizing damage to surrounding Nov 23, 2012 · Percutaneous removal of upper urinary tract calculi is a well established procedure. Extravasation of glycine irrigant during percutaneous ultrasonic lithotripsy has caused a transurethral resection syndrome consisting of hypertension, confusion and hyponatremia. In this procedure, focused ultrasound waves are used to disrupt the gallstones and the fragments formed are carried in the bile into the small intestines and subsequently eliminated from the body. Jun 29, 2024 · urination The suffix -lith means stone A percutaneous ultrasonic lithotripsy is performed to crush kidney stones Aug 18, 2013 · Objectives. Sep 13, 2023 · The patients’ gallstones were successfully removed via percutaneous ultrasonic lithotripsy during a collaborative procedure with interventional radiology and urology. INTRODUCTION Percutaneous ultrasonic lithotripsy (PUL) is a new tech- nique used ìn the treatment of renal stones. Lithotripsy is a procedure involving the physical destruction of hardened masses like kidney stones, [1] bezoars [2], gallstones or sialolithiasis. The shock waves break a large stone into smaller stones that will pass through the urinary system. Nephrostomy tube D. nephropathy Suffix and its meaning: -pathy (disease) Combining form and its meaning: nephr/o (kidney) Medical word definition: Pathological disease of the kidney 3. Read the medical word. Sep 22, 2024 · Medical word definition: Surgical repair of a ureter 2. By understanding the differences between percutaneous nephrolithotomy and shock wave lithotripsy, patients can make an informed decision about The objective of the study was to compare the outcome of PCNL using pneumatic lithotripsy alone and combined lithotripsy (pneumatic and ultrasonic). Ultrasonic lithotripsy employed with a percutaneous nephroscope is a safe, controlled method of removal of renal and ureteral stones using the techniques described herein. ESWL works best for smaller kidney stones (less than 2 cm). Mechanical or electrohydraulic lithotripsy may be used as an alternative or adjunct to ultrasonic lithotripsy. Percutaneous Nephrolithotomy or Nephrolithotripsy Treatment Overview This procedure is used to remove kidney stones. Methods: A literature search was performed to identify all types of older and newer generation ultrasonic Jun 7, 2024 · Percutaneous nephrolithotomy and lithotripsy are surgical interventions used to treat kidney stones, a prevalent issue among populations worldwide. Dec 15, 2023 · Background: Ultrasonic and pneumatic lithotripters are the gold standard for percutaneous nephrolithotripsy. and more. Percutaneous lithotripsy of kidney stones by ultrasound or by the related techniques of electrohydraulic or mechanical lithotripsy is covered under Medicare. Abstract Purpose: Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Why PCNL vs SWL or URS? Nov 23, 2012 · Percutaneous removal of upper urinary tract calculi is a well established procedure. Multitract PNL: The advancement of nephroscopes and instruments allows PNL with 15–20 CH working channels. Intracorporeal lithotripsy devices for percutaneous nephrolithotomy (PCNL) vary in terms of energy source, mechanism of action, probe features, Ultrasonic lithotripsy employed with a percutaneous nephroscope is a safe, controlled method of removal of renal and ureteral stones using the techniques described herein. The term is derived from the Greek words meaning "breaking (or pulverizing) stones" (litho- + τρίψω [tripso]). nephropathy Suffix and its meaning: Combining form and its meaning: Medical word definition: View full document 3. Since its introduction in 1976, many aspects of the operative technique and the endoscopic equipments have had constant evolution, increasing the success rates of These cases demonstrate that percutaneous cholecys-tolithotomy with rigid ultrasonic lithotripsy is an effective method for removing challenging gallstones in patients for whom traditional approaches fail. Jun 1, 1984 · Percutaneous ultrasonic lithotripsy has become a primary therapeutic modality for safe and rapid removal of symptomatic renal calculi. Urethral stent C. Radiologic involvement has been basic to clinical applica tion of this modality. Whereas extraction techniques are effective for small calculi, larger or impacted stones require fragmentation before removal. Lithotripsy uses ultrasound shock waves to break kidney stones into smaller pieces that can be eliminated in the urine. Ultrasonic and pneumatic lithotripsy differed in the time for stone fragmentation and removal for hard and soft stones. May 31, 2023 · Lithotripsy is a procedure that uses shock waves or lasers to break down stones in the kidneys, bladder, or ureters. The key message of this report is the management of de novo kidney allograft stones using endoscopic lithotripsy techniques, such as percutaneous nephrolithotomy. There are five major types of lithotripters, which include pneumatic, ultrasonic, combination of ultrasonic and ballistic, Lithotripsy is a procedure used to treat kidney stones that are too large to pass through the urinary tract. Our research includes both clinical and Percutaneous renal calculus removal has evolved rapidly over the past 4 years. Pneumatic lithotripsy (Lithoclast®) is effective regardless of the stones' composition, and ultrasonic lithotripsy allows the aspiration of small debris during lithotripsy. lithotripsy (as in percutaneous ultrasonic lithotripsy) Medical word definition: Enlarg ement and twisting of the veins if the spermatic cord narrowing of the opening of the prepuce and the for eskin cannot be drawn back Older techniques of stone fragmentation include ultrasonic lithotripsy, a pneumatic hammer (lithoclast), or electrohydraulic lithotripsy (EHL). Jul 1, 2023 · Definition Lithotripsy is a procedure that uses shock waves to break up stones in the kidney and parts of the ureter (tube that carries urine from your kidneys to your bladder). Intracorporeal lithotripsy is one of the most important steps that affect the success rate of this surgical method, and for this step pneumatic and ultrasonic lithotripters are commonly used energy sources [3]. Inourseriesofover800patients, renalcalculus removalhasbeensuccessful inover95%[6]. In our new chart, we summarize the benefits and drawbacks of each surgical option. Lithotripsy A non-invasive treatment for gallstones, involving the use of ultrasonic vibrations, known as lithotripsy, can be performed. 5 A number of lasers have been trialed for the LL method, that the holmium: yttrium-aluminum-garnet (Ho: YAG) was the most commonly used treatment. After the procedure, the tiny pieces of stones pass out of your body in your urine. A small hollow tube is placed directly through a patient’s back into the kidney through which larger instruments can then be used to fragment and extract the stone (s). Although this approach typically requires a hospital stay and is more invasive than ureteroscopy or extracorporeal shockwave lithotripsy, it is often the most See full list on browardurologycenter. d) "Take your temperature every 4 hours. It uses high-energy shock waves to break stones into tiny fragments that can be more easily passed through urine. The nurse anticipates that the client's care will involve monitoring which of the following? A. In nephrolithotomy, Opens dialog , the doctor removes the stone through the tube. Aug 29, 2004 · To report the procedure, O'Dell settled on these CPT codes: CPT Code 50081 (Percutaneous nephrostolithotomy or pyelostolithotomy, with or without dilation, endoscopy, lithotripsy, stenting or basket extraction; over 2 cm) for the nephrostolithotomy and stone removal (the percutaneous nephrostomy and ultrasonic lithotripsy). It works by sending focused ultrasound energy or shock waves directly to the stone. This study aimed to compare the efficiency of high-power holmium YAG laser and ballistic INTRACORPOREAL LITHOTRIPTORS Ultrasonic and pneumatic lithotriptors are the most commonly used energy source for percutaneous lithotripsy, fragmenting stones with high success rates and minimal soft tissue effects. Aug 18, 2013 · Objectives. Their large gallstones remained refractory to attempts at removal by electrohydraulic lithotripsy via the cholecystostomy access. A success rate of 95 to 98 per cent should be achievable. Sep 20, 2023 · Learn more about laser lithotripsy, a procedure that breaks up stones in your kidney, bladder, ureter or urethra. Percutaneous ultrasonic lithotripsy, endoscopically guided removal of fragments through a percutaneous track, is becoming a widely used method for removal of symptomatic renal and Study with Quizlet and memorize flashcards containing terms like For what does the urinary bladder serve as a reservoir?, The word root cyst means __________. ", The nurse is providing postprocedure care for a client who underwent percutaneous lithotripsy. Stand alone ultrasound lithotripsy for fast evacuation of softer – medium hard kidney stones through either standard or mini- percutaneous access or through semi-rigid ureteroscopes for ureteric stones. Jackson-Pratt Lithotripsy Extracorporeal shock wave lithotripsy; Shock wave lithotripsy; Laser lithotripsy; Percutaneous lithotripsy; Endoscopic lithotripsy; ESWL; Renal calculi-lithotripsy Lithotripsy is a procedure that uses shock waves to break up stones in the kidney and parts of the ureter (tube that carries urine from your kidneys to your bladder). This article elucidates the differences and individual attributes of these techniques, focusing particularly on their effectiveness as stone-removal therapies. Clinical experience has proven this modality to be safe, reliable, and effective for treatment of symptomatic renal Nov 17, 2010 · Purpose Percutaneous nephrolithotomy (PCNL) is the procedure of choice for treating large renal stones. Mar 7, 2024 · For renal stones > 20 mm, percutaneous nephrolithotomy (PNL) offers the best stone clearance rates with acceptable complication rates. After overcoming specific technical problems, ultrasonic lithotripsy was successfully used to crush smaller stones and for the percutaneous disintegration of kidney stones with the nephroscope. Larger, straight access tracts allow for use of rigid pneumatic and ultrasonic lithotripsy devices. xqs kmustxj 1f 35ma4r mkp jimv jsef jz 1u3 9ltj