HOW I DO IT

• How I Do It: ERAS protocol featuring erector spinae plane block for percutaneous nephrolithotomy

  Zhang Bertie, Ochuba J. Arinze, Mullen R. Gregory, Rai Arun, Aro Tareq, Hoenig M. David, Okeke Zeph, Winoker S. Jared The Smith Institute for Urology at Lenox Hill, Zucker School of Medicine at Hofstra/Northwell Health, New York, New York, USA

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  Percutaneous nephrolithotomy (PCNL) is the gold-standard treatment for large and complex renal stones. Though associated with higher stone-free rates compared to other minimally invasive stone procedures, this comes at the expense of increased morbidity including postoperative pain and discomfort. We describe our enhanced recovery after surgery (ERAS) protocol for PCNL with emphasis on the use of erector spinae plane blocks to improve patient satisfaction and reduce postoperative opioid use and bother.

  Keywords: regional anesthesia, PCNL, ERAS, multimodal pain control,

  Aug 2023 (Vol. 30, Issue 4 , Page 11639)
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• The prone ureteroscopic technique for managing large stone burdens

  Sternberg M. Kevan, Jacobs L. Bruce, King J. Benjamin, Wachterman B. Jared, Shahrour Khaled, Theisen M. Katherine, Sprauer E. Sarah, Ohmann Erin, Averch D. Timothy, MD University of Vermont, Burlington, Vermont, USA

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  Percutaneous nephrolithotomy (PCNL) is the standard treatment for patients with large stone burdens, but can be associated with significant complications. Flexible ureteroscopy is an alternative approach that is less invasive, but often requires multiple procedures. Typically, many factors play a role in the decision to perform PCNL or ureteroscopy. The challenge is that it is difficult to predict which stone burdens will be able to be cleared ureteroscopically. We describe our approach using initial prone ureteroscopy with the transition to standard prone PCNL if required.

  Keywords: percutaneous nephrolithotomy (PCNL), prone ureteroscopy, ureteroscopy, renal calculi, shock wave lithotripsy (SWL),

  Apr 2015 (Vol. 22, Issue 2 , Page 7758)
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