Use of Carbon Dioxide Contrast for Nephrostolithotomy of Staghorn Calculi

Abstract

We describe a combined positive (iodinated contrast medium) and negative (carbon dioxide) contrast technique to facilitate percutaneous tube placement for nephrostolithotomy of staghorn calculi. This technique, which can be used either retrograde or antegrade, facilitates identification of the posterior calices for nephrostomy puncture and helps the operator identify the space between the stone and the caliceal wall. With it, we have been able to enter a posterior calix in 44 consecutive patients who had branched renal calculi.