PROCEDURE:Â
- Antegrade nephrostogram
- Percutaneous nephrostomy tube placement
INDICATION:Â Â Â Â
DATE:Â Â Â Â
OPERATING PHYSICIAN:Â
MEDICATIONS: Levaquin 500 mg IV, Versed   mg IV, Fentanyl   mcg IV
CATHETER:Â Â Â Â
CONTRAST:Â Â Â Â
FLUOROSCOPY TIME:Â Â Â Â
PROCEDURE:
The risks benefits and alternatives of the procedure as well as conscious sedation were discussed with the ___. After obtaining informed consent the patient was prepped and draped in the usual sterile fashion. 1% lidocaine was used as local anesthetic. Under   guidance a 22 gauge Chiba needle was introduced into the ____. An 0.018 wire was then passed through the needle into the renal pelvis. The needle was then removed and a 6 French coaxial dilator was placed over the wire. Subsequently, the wire and inner dilator were removed and an 0.035  ____wire was placed through the dilator. An antegrade nephrostogram was then performed. The dilator was then removed and a  ___French percutaneous nephrostomy tube was placed with the cope loop formed within the renal pelvis. The nephrostomy tube was then anchored to the skin utilizing ___.
The patient tolerated the procedure well and left the angiography suite in stable condition without any immediate postprocedural complications.
FINDINGS:
Antegrade nephrostogram demonstrates   Â
IMPRESSION:Â Â Â Â
Frequently Asked Questions
What is a percutaneous nephrostomy tube placement?
Percutaneous nephrostomy tube placement is a medical procedure used to drain urine from the kidney when normal flow is obstructed. It involves inserting a tube through the skin into the kidney, allowing for urine diversion directly from the renal pelvis. This helps alleviate symptoms associated with urinary obstruction and prevents kidney damage.
The procedure begins with discussing risks, benefits, and alternatives with the patient, followed by obtaining informed consent. After administering local anesthesia, a needle is guided into the kidney using imaging techniques. A wire is introduced to guide the placement of a dilator, and eventually, the nephrostomy tube is placed into the renal pelvis. The tube is secured to the skin, ensuring stable urine drainage.
What are the risks associated with percutaneous nephrostomy?
Risks of percutaneous nephrostomy include bleeding, infection, and injury to surrounding organs. There is also a risk of dislodgement or blockage of the nephrostomy tube. However, these risks are generally low, and the procedure is considered safe when performed by experienced professionals.
What are the indications for percutaneous nephrostomy tube placement?
Indications for percutaneous nephrostomy include urinary obstructions due to kidney stones, tumors, or strictures. It may also be used in cases of infection or injury where urine flow needs to be temporarily diverted to allow for healing or to relieve symptoms.
What medications are typically used during a nephrostomy procedure?
Medications used during the procedure often include antibiotics like Levaquin to prevent infection, and sedatives such as Versed, along with pain management drugs like Fentanyl. These help ensure patient comfort and minimize the risk of complications during the procedure.
What is an antegrade nephrostogram?
An antegrade nephrostogram is an imaging study performed during a nephrostomy procedure. It involves injecting contrast dye into the renal pelvis to visualize the urinary tract and ensure proper placement of the nephrostomy tube. This helps in identifying any obstructions or abnormalities in the urinary system.
How long does a percutaneous nephrostomy tube stay in place?
The duration a nephrostomy tube remains in place varies depending on the underlying condition. It can be temporary, until the obstruction is resolved, or long-term if permanent diversion is necessary. The healthcare provider will determine the appropriate duration based on the patient's specific needs.
Can you explain the term 'conscious sedation' used in the procedure?
Conscious sedation refers to a combination of medications used to help patients relax and minimize discomfort during medical procedures. Patients remain awake but are calm and may not remember the procedure afterward. This type of sedation allows for easier communication and cooperation during the procedure.
What post-procedural care is needed after nephrostomy tube placement?
Post-procedural care includes monitoring for signs of infection or complications, keeping the tube site clean and dry, and ensuring the tube remains unobstructed. Patients may need follow-up imaging to assess tube placement and renal function, and they should report any symptoms like fever, pain, or leaks immediately.