TIPS & TRICKS - Stone in a Diverticulum

Stone in a Diverticulum — Combined Antegrade Puncture and Retrograde Ureteroscopy

This case shows a stone in a diverticulum that has previously undergone a failed retrograde ureteroscopy. An antegrade access is achieved first with a direct puncture in the diverticulum. This helps to guide a retrograde ureteroscopy procedure to the diverticulum. The diverticulum is opened with a laser to gain access to the stones. The stones are then repositioned and fragmented by the laser. Afterwards, these fragments are removed. When the complete stone clearance has been achieved, the antegrade catheter is removed under vision. The ureteroscope is then withdrawn under vision and a 6 Fr double lumen stent is left in position.