Renal Distraction During Percutaneous Renal Calyceal Access for Prone & Supine PCNL Using a Ureteric Balloon Catheter (UBC)
Bibliographic record
Abstract
Special access techniques during percutaneous nephrolithotomy (PCNL) are indicated for challenging stones. Various techniques have been described to inferiorly displace the kidney to facilitate optimal percutaneous access whilst minimizing thoracic complications associated with the supracostal approach. We describe our institution’s technique of using a ureteric balloon catheter to inferiorly distract and immobilize the kidney (UBC Technique) to achieve the optimal calyceal access infracostally during PCNL. This permits effective and safe access in a single puncture whilst additionally stabilizing the renal unit during respiration and reducing the skin-to-calyceal distance by mobilizing the desired calyx in line with the axis of the puncture needle. We reviewed the literature regarding alternative inferior renal displacement techniques permitting infracostal approaches. From May 2012 to October 2017 150 PCNLs were performed in our institution. Out of these, the UBC technique was used in 18 cases during both prone and supine PCNLs. In all cases, the UBC technique was used successfully to access the most desirable calyx. No complications associated with renal distraction were reported. Post operatively, 1 patient required a blood transfusion, 1 patient had a pyrexia of >38 degrees resulting in a longer admission and 1 patient developed sepsis requiring HDU admission for monitoring only. 15 out the 18 patients had complete stone clearance from their PCNL. The UBC technique provides a safe alternative to the supracostal approach in percutaneous renal surgery. It is less traumatic than alternative infracostal access techniques and has a very short learning curve.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
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 | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".