Ultrasound guided dual tract supine PCNL with simultaneous use of two different energy sources by two urologists working in unison-an innovative approach in staghorn calculus

Ultrasound guided dual tract supine PCNL with simultaneous use of two different energy sources by two urologists working in unison-an innovative approach in staghorn calculus

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Complete staghorn renal calculi are surgical challenge requiring multi-tract or staged PCNL.We report a case of supine PCNL where complete stone clearance was achieved with dual tracts (24 Fr/lower pole and 16Fr/upper pole) through which two surgeons operated simultaneously using two different energy sources (pneumatic/ultrasound lithotripter Managing Food Quality Risk in Global Supply Chain: A Risk Management Framework through 24Fr and Thulium Fiber laser through 16Fr).Strong water currents generated by dual-tract irrigation augmented the mini-PCNL venturi effect facilitating stone fragment evacuation.This is first reported case of two surgeons operating simultaneously using two different energy sources, Áreas verdes y arbolado en Mérida, Yucatán. Hacia una sostenibilidad urbana in supine position in a limited space on a complete staghorn stone.