Microperc

Microperc is a modified percutaneous nephrolithotomy procedure in which the percutaneous access to the pyelocalyceal system and the subsequent nephroscopy are performed in a single step using a dedicated 4.85 ch. instrument, the “all-seeing needle.” This approach reduces tract-related morbidity, such as bleeding and urinary tract disruption, by decreasing its size to a minimum and by limiting the steps necessary for its establishment. Due to the limited dimensions of the instrument, lithotripsy is performed through a 200 μm laser fiber. Complete dusting should be achieved by protracted lithotripsy since litholapaxy is not possible through the miniaturized sheath, restricting this technique to small-to-medium size stones. Microperc, being characterized by satisfactory stone clearance rates and limited morbidity, appears to be a good alternative to ureteroscopy, shock-wave lithotripsy and mini-percutaneous nephrolithotomy for the treatment of stones smaller than 15–20 mm. Therefore, microperc can be employed in case of contraindications to or failure of other treatments, to perform an ancillary access during other endourological procedures or to perform a minimally invasive percutaneous treatment of kidney stones in the pediatric population.