Description
The modern day endourologist has an extraordinary array of instruments and ancillary gadgets at his disposal that could only have been dreamt about 15 years ago and could not possibly have been conceived 30 years ago. A patient presenting in the new millennium with a ureteric or renal calculus can r ealistically anticipate full stone clearance either by extracorporeal techniques or by minimally invasive endoscopic alternatives that will not require an incision and can be performed with predictably low morbidity. There have been remarkable developments in the technique of lithotomy from the itinerant lithotomists of the nineteenth century (Figure 1.1) to the modern day stone surgeon. This has only become possible from the coming together of industrial expertise with urologists to develop ever -smaller diagnostic endoscopes and therapeutic ancillary instruments. Each new revolution in endoscopic design has allowed access to more remote areas of the genitourinary system and although initially diagnoses were eminently feasible, therapeutic options were limited. Miniaturisation of the therapeutic instruments has initially lagged berund endoscopic design, but our manufacturing colleagues have usually caught up. As a result the revolution in endoscopic management of bladder lesions that occurred toward the end of the last century is now being repeated in the treatment of pelvicalyceal pathologies.
In tills chapter we will outline the basic generic principles that govern endourology techniques from rigid urethroscopy to flexible ureterorenoscopy. The specific techniques applicable for each procedure will be listed in the relevant chapter. Laparoscopic procedures are beyond the remit of till textbook.