Treatment for complete staghorn calculus with mild hydronephrosis-

Ans. (d) PCNLRef: Bailey & Loves Short Practice of Surgery 27th Ed; Page No- 1409PCNL* It is done using a special instrument Nephroscope.* It has minimum morbidity.* It has similar success to open surgery.* In PCNL operation; you have to stay short time in hospital.* The overall cost may not be different from open and PCNL operation.* Indications:# Infected calculi.# Large calculi >2cm size# Obstructive uropathies# Cystine calculi# Failed ESWL# Anatomic abnormalities# Recurrent large calculi after open operation.* Complications:# Septicemia: More with Struvite calculus.# Bleeding blood transfusion: 3-10%# Perforation and extravasation of fluid.# Pleural injury: Upper calycleal puncture.# Liver and spleen injuries-Rare# Duodenal Injury/Colon injury (Subcostal approach)# Injury to vessels: Renal vein, Renal Artery and IVC -rare.