nephroscope

A nephroscope is an endoscopic instrument designed to visualize the interior of the kidney and to facilitate intrarenal procedures. It is used to inspect the renal collecting system, diagnose intrarenal pathology, and aid in the fragmentation and removal of kidney stones. In percutaneous nephrolithotomy (PCNL), the nephroscope is inserted through a small flank incision and advanced via a percutaneous tract into the kidney. It provides direct visualization and a working channel for instruments such as graspers, suction, and lithotripsy probes, as well as for irrigation to maintain a clear view.

Nephroscopes come in rigid and flexible forms. Rigid nephroscopes offer a stable pathway for instrumentation and are commonly used in straight-line access through a percutaneous tract. Flexible nephroscopes have deflectable tips and can navigate to multiple calyces, improving access to complex stone burdens or intrarenal lesions, though they may require more specialized equipment and training.

Indications for nephroscopic use include management of nephrolithiasis, evaluation of unexplained hematuria, investigation of intrarenal masses, and assessment of congenital renal anomalies. The device can be used solo or with adjunctive technologies such as laser or pneumatic lithotripsy, depending on the clinical scenario and surgeon preference.

Complications associated with nephroscopy are generally related to intrarenal endoscopic procedures and may include bleeding, infection or sepsis, injury to the renal parenchyma or collecting system, urine leakage, and injury from instrumentation. Nephroscopy is often chosen when direct intrarenal visualization and access are advantageous compared with alternative approaches.