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| Miniaturization in percutaneous nephrolithotomy: What is new? |
Wei Zhu,Zhicong Huang,Guohua Zeng( )
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| Department of Urology and Guangdong Key Laboratory of Urology, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China |
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Abstract Objective To summarize recent advancements in mini-percutaneous nephrolithotomy (mini-PCNL) in surgical technique, stone removal strategy, lithotripsy, and surgical model from the current literature.
Methods We conducted a narrative review of relevant English-language articles up to October 2022 using the PubMed and Web of Science databases. The following keywords were used in the search: “percutaneous nephrolithotomy”, “minimally invasive percutaneous nephrolithotomy”, “mini-PCNL”, “mini-perc”, “mPCNL”, and “miniaturization”.
Results A series of new progress has been made in many aspects of mini-PCNL, such as further reduction of tract size—needle perc and further improvement of robotic-assisted PCNL—artificial intelligence-powered robotic devices.
Conclusion Many studies and trials have been conducted to reduce morbidity and increase the safety and effectiveness of mini-PCNL. It is crucial to realize that miniaturization of PCNL requires not only a smaller percutaneous tract size, but also an adjustment strategically in renal access, stone removal, lithotripsy, and surgical model in general. More large-scale prospective research needs to be carried out to further validate and optimize the safety and effectiveness of mini-PCNL.
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Received: 16 October 2022
Available online:
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Corresponding Authors:
Guohua Zeng
E-mail: gzgyzgh@vip.sina.com
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| Term | Access sheath, Fr | Reference | | Mini-PCNL | ≤22 | Jackman et al. [1] | | Minimally invasive PCNL | 9.5-26 | Nagele et al. [9] | | Chinese minimally invasive PCNL | 14-20 | Zeng et al. [8] | | Ultra-mini PCNL | 11-13 | Desai and Solanki [10] | | Super-mini PCNL | 10-14 | Zeng et al. [12] | | Micro-PCNL | 4.8 | Desai and Mishra [11] | | Needle-perc | 4.2 | Xiao et al. [7] |
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Current nomenclature of mini-PCNL techniques.
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4.2 Fr needle-perc [7].
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Super-mini percutaneous nephrolithotomy system [12,13].
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