V01-06: MINIPERC: YES, PLEASE!
In an effort to reduce PCNL related morbidity, some urologists have progressively introduced the mini-perc technique in paediatric endourology. There was initial skepticism about its potential owing to the lack of a dedicated armamentarium. But the development of miniaturised nephroscopes, the understanding of the physics behind the vacuum cleaner effect together with the increased efficacy of modern holmium laser generators and the skill of surgeons led to widespread dissemination of the technique. The aim of this video is to describe the outcomes of our series of patients who underwent mini-nephrolithotomy (MINIPERC) and to show step by step the details of the technique.
A prospective analysis of 157 consecutive patients who underwent MINIPERC at our institution between September 2016 and September 2018, was performed. Intraoperative and postoperative outcomes were assessed. Abdominal noncontrast computerized tomography (NCCT) scan was performed in all cases preoperatively and 1-month postoperatively. Patients were reported to be stone free if there were no residual fragments. Peri/postoperative complications were reported according Clavien-Dindo classification system. The primary endpoint of the study was stone free rate (SFR) and the secondary endpoints were Clavien-Dindo complications grade 1 or higher.
The outcomes are reported in the Table 1.
MINIPERC is an effective and safe technique for treating medium-size renal stones that represents a reasonable a middle ground between standard perc and flexible ureteroscopy. Dedicated modern highly technological armamentarium is the key to succeed.