ABSTRACT
Percutaneous cryoablation or radiofrequency ablation highest sensitivity for identifying renal calculi and masses, due to the axial imaging of computed tomography, some anatomical variants such as a bifid renal pelvis may be more apparent on Intravenous pyelogram which images the kidney in the anterior to posterior view. Proper preoperative evaluation is the cornerstone to preventing complications. Having accurate knowledge of patient risk factors can allow correction preoperatively and increased caution intra-operatively. The upper pole of both kidneys lies anterior to the 11th and 12th ribs. Supra-12th rib access is usually transthoracic but extrapleural whereas supra 11th rib access is transthoracic and transpleural. Electrohydraulic (EHL) energy can be used to fragment stones; however, the emitted spark is also capable of damaging the telescope or the collecting system. The EHL probe should always be placed in direct contact with the stone to prevent complications.
