Open Access

ARTICLE

Renal track creation for percutaneous nephrolithotomy: the history and relevance of single stage dilation

Frank T. D’Arcy¹, Nathan Lawrentschuk^1,2,3, Rustom P. Manecksha^1,4, David R. Webb¹

1 University of Melbourne, Department of Surgery, Austin Health, Melbourne, Victoria, Australia
2 The Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
3 Olivia Newton-John Cancer Research Institute, Austin Hospital, Melbourne, Victoria, Australia
4 Department of Urology, St James Hospital and the Adelaide and Meath Hospital, Dublin, Ireland
Address correspondence to Professor David R. Webb, Urology Unit, Department of Surgery, Austin Health, Heidelberg 3084, Melbourne, Victoria, Australia

Canadian Journal of Urology 2015, 22(5), 7978-7983.

Abstract

Introduction: Percutaneous nephrolithotomy (PCNL) was described in the 1980s and revolutionized the treatment of stone disease. The crucial component to this surgery is satisfactory track creation. We examine how the development and production in the 1980s of a single stage dilator (SSD) subsequently modified for pediatric PCNL has become the ideal access tool for mini percutaneous nephrolithotomy (mPCNL) today.
Materials and methods: The conception, production, scientific and clinical development of the original SSD is described. The pitfalls of track dilation in general according to method of dilation are also discussed and outlined.
Results: This study provides evidence clarifying commonly held misconceptions about the origin of SSD which is the mainstay of the mPCNL technique.
Conclusions: Percutaneous renal surgery continues to evolve. In less than 40 years stone surgery has transformed from a morbid open operation to a number of minimally invasive, routine techniques. The SSD has been an innovation that has played a crucial role in this change.

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