Intraoperative localisation and management of renal calculi during nephrolithotomy by real-time ultrasonography.

Objective: To evaluate the role of ultrasound as a sole procedure for intraoperative localisation and management of complex renal calculi.

Material And Methods: Between September 1997 and November 2001, 16 patients underwent complex surgery for multiple, large or recurrent renal stones using the ultrasound image as a the sole intraoperative diagnostic procedure. A 8.5 MHz sector transducer with a pulse Doppler signal was used to identify the avascular area, the shortest distance between the renal surface and the stone.

Results: Complete stone removal was achieved in all patients without complications.

Conclusion: Intraoperative sonography for localisation of the intrarenal arteries combined with B scan sonography for intraoperative localisation of stones allows complete removal via radial nephrotomies without peduncle clamping and cooling procedure. The advantage is the exact and quick localisation of stones avoiding X-ray.