Thoracoscopy-Assisted High Intercostal Percutaneous Renal Access
Bibliographic record
Abstract
PURPOSE: We describe a technique for safely accessing an upper pole calix through a 9th or 10th intercostal puncture. PATIENTS AND METHODS: A 9th or 10th intercostal access was used for percutaneous nephrolithotomy (PCNL) in nine patients. Thoracoscopy via the 5th or 6th intercostal space was used to ensure safe passage of the nephrostomy needle. RESULTS: Access was obtained in all patients without visceral injury. Seven patients were stone free after PCNL; the initial two required sandwich therapy to become so. Chest tubes were inserted routinely in the first eight cases. They were removed on postoperative day three and did not affect the length of hospital stay. CONCLUSIONS: Access through the 9th or 10th intercostal space is occasionally necessary and is ideal in certain circumstances. Thoracoscopy-assisted percutaneous renal access allows access under direct vision, thus preventing pulmonary injury.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".