STEP ONE

URETEROSCOPE ENTRY

The flexible ureteroscope sets the puncture trajectory in perfect alignment with the infundibulum.

STEP TWO

PUNCTURE WIRE ADVANCEMENT

Puncture wire advanced.

STEP THREE

LOAD EXCHANGE CATHETER

Catheter loaded over puncture wire.

STEP FOUR

WITHDRAW URETEROSCOPE

Advance exchange catheter as Ureteroscope is drawn down.

STEP FIVE

REMOVE URETEROSCOPE

Remove ureteroscope, puncture wire, and inner catheter, leave in place outer catheter and ureteral access sheath.

STEP SIX

ADVANCE NEW 0.035” NEPHROSTOMY WIRE

Advance Nephrostomy Wire Through Outer Catheter, Then Remove Outer Catheter.

STEP SEVEN

0.035” NEPHROSTOMY WORKING WIRE IN POSITION

Through-and-through, 0.035” nephrostomy working wire in position.

STEP EIGHT

NEPHROSTOMY BALLOON LOADED OVER WORKING WIRE

Nephrostomy sheath is advanced over nephrostomy balloon.

Nephrostomy balloon is advanced.

STEP NINE

NEPHROSTOMY BALLOON INFLATED

Nephrostomy balloon is inflated.

STEP TEN

NEPHROSTOMY SHEATH ADVANCED OVER BALLOON

STEP ELEVEN

NEPHROSTOMY SHEATH IN PLACE, BALLOON REMOVED

Nephrostomy sheath in perfect alignment with infundibulum, avoiding injury and bleeding.