# Nephroureterostomy Tube Placement



## drobinson1 (Feb 16, 2010)

Can someone give me a little assistance. I was thinking of using 74480/50393 but I'm not sure about report. It mentions a Nephrostogram but it was before the tube placement. So would it be 74425/50390-59/74480/50393?


The patient was placed on the angiography table in the prone position. Ultrasound evaluation of the right kidney demonstrated mild hydronephrosis (image on file). An appropriate puncture site into the renal pelvis was selected, anesthetized with 10 cc of subcutaneous lidocaine and a smalll incision was made. With continuous ultrasound guidance a 21-gauge needle was advanced into the renal pelvis. An antegrade nephrostogram was performed, which demonstrated mild hydronephosis and an obstructing renal calculus within the proximal ureter. With fluoroscopic guidance, a mid pole calix was selected, and anesthetized with 10cc of subcutaneous lidocaine. A small incision was made, and a 21-gauge Chiba needle was advanced into a mid pole calix under fluoroscopic guidance. A 0.018 inch gude wire was advanced into the renal collecting system,and the needle was exchanged for an Accustick catheter, which was advanced beyond the obstructing calculus into the right ureter. A 4-French Kumpe catheter was then advanced over a 0.035 inch heavy guidewire to the urinary bladder, and the catheter was exchanged for 10 French dilator, which was then exchanged for a 10 French x 24cm French percutaneous Nephroureterostomy tube, which was looped in the renal pelvis.The catheter was attached to the skin with two 3-0 prolene sutures and an external drainage bag.


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## HNISHA (Feb 16, 2010)

Exactly I would use the same..


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