A novel 5-part Percutaneous Access Needle with Glidewire technique (5-PANG) for percutaneous nephrolithotomy: our initial experience.

OBJECTIVES: To describe the use of an innovative 5-part Percutaneous Access Needle with Glidewire (5-PANG), a novel technique in an attempt to make percutaneous nephrolithotomy (PCNL-a routinely performed procedure) tract establishment a fast, safe, and less cumbersome procedure.
METHODS: An access needle (5-PANG needle) was designed and fabricated at the Institute of Urology, Dhule, and used for percutaneous renal access during PCNL.
RESULTS: The 5-PANG technique was used in 55 cases (57 renal units). It was used for all calyceal punctures, all types of stones, renal anatomies, and for second-time surgeries (8 cases). The mean time required (from the stage of the successful puncture using the first 3 parts of the needle till the placement of Alken's rod) was 44.54 seconds. The radiation time was a mean of 3.34 seconds. Punctured calyx and tract size did not affect the results. Visual clarity was good in 85.9% cases. No case had to be converted to conventional method or abandoned. There were no intra- or postoperative complications related to the 5-PANG.
CONCLUSIONS: We find the 5-PANG technique safe, fast, effective, and inexpensive. It is easy to learn and master. We recommend this technique over the standard initial tract dilatation techniques. Copyright 2010 Elsevier Inc. All rights reserved.