by dr. janak desai (m.s., m.ch.) dr. ronak solanki (m.s.) samved hospital ahmedabad, india

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ULTRA-MINI PCNL (UMP) BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

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Page 1: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

ULTRA-MINI PCNL (UMP)

BYDR. JANAK DESAI (M.S., M.Ch.)

DR. RONAK SOLANKI (M.S.)

SAMVED HOSPITAL AHMEDABAD, INDIA

Page 2: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

UMP BASIC EQUIPMENTS

Page 3: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

INITIAL PUNCTURE AND DILATATION

Page 4: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

UMP ACCESS SHEATH

Page 5: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

UMP ACCESS SHEATH

Channel for Water jet

Page 6: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

UMP OBTURATOR

Grooved Obturator

Page 7: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

UMP ENDOSCOPE WITH SHEATH

Channel for Laser

Irrigation Channel

Page 8: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

ENDOSCOPE INSERTION

Page 9: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

BLOOD CLOTS REMOVAL WITH 3FR UMP FORCEPS

Page 10: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

POSITION OF LASER FIBER

LASER FIBER

(200 Micron)

Page 11: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

DISINTEGRATION OF STONE

Page 12: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

SPECIALLY DESIGNED SHORTPROBE FOR LITHOCLAST

Page 13: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

SPECIALLY DESIGN SHORT PROBE FOR LITHOCLAST

Page 14: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

EFFECTS OF WATER JET

Page 15: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

WATER JET CHANNEL

Page 16: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

OUTLET OF WATER JET CHANNEL

Page 17: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

WATER JET

Page 18: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

EXTRACTION OF FRAGMENTS USING WATER JET

Page 19: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

EXTRACTION OF FRAGMENTS USING LOW SUCTION

Page 20: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

EXTRACTED STONE FRAGMENTS

Page 21: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

SIZE OF STONE FRAGMENTS

Page 22: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

NO NEPHROSTOMYNO DJ STENT

Page 23: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

NO NEPHROSTOMYNO DJ STENT

4mm Puncture with No Bleeding

Page 24: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

Minimal Parenchymal Damage. Minimal Bleeding. 24-Hours or Less Hospitalization. Very Less Usage of Analgesics. No Double – J Stenting. Stone Clearance Rate Very High (In our

series better than RIRS). Good for Paediatric as well as Adult

patients. No Nephrostomy.

ADVANTAGES

Page 25: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

Instrumentation not possible. Clot removal difficult. Time Consuming.

DISADVANTAGES

Page 26: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

We believe UMP is one more armamentarium for Kidney Stone removal.

NEW TECHNIQUE ON THE HORIZON

Page 27: BY DR. JANAK DESAI (M.S., M.Ch.) DR. RONAK SOLANKI (M.S.) SAMVED HOSPITAL AHMEDABAD, INDIA

Thank you