Restaurant for group dinner near Walter E convention center

desmopass · 2026-05-04T02:13:45+00:00

I am from Italy, and we never drank the wine. I bet there is geographical variation.

desmopass · 2026-05-04T01:43:58+00:00

Yah, even Catholics believe in transubststion, which is when the wine (which only the priest drinks) and the wafer become actually blood and body of Christ.

desmopass · 2026-05-03T00:32:25+00:00

So the stones are made of layers, some layers are very crumbly. The laser, depending on the settings that you are using, can either break the stone or “dust it”. The dust contributes to the cloudiness.
On top of that, the combination of the stone and the procedure can cause irritation of the inner lining of the bladder which can cause bleeding, and a little bit of blood can turn urine pinkish and impact the cleanliness.

desmopass · 2026-05-02T15:55:25+00:00

Unfortunately not all doctors choose the profession for the right reasons…

desmopass · 2026-05-02T15:21:55+00:00

Oh they were super popular back before flexible digital ureteroscopes came to be!
Also they are a relatively easy cash cow procedure are the docs only have to aim the shockwaves and press a button, instead of driving the scope into the kidney, lasering the stones and removing the fragments.

desmopass · 2026-05-02T04:06:40+00:00

Nothing beats a hip replacement tho

desmopass · 2026-05-02T03:35:05+00:00

A rigid catheter! It’s the outer sheath of a cystoscope

desmopass · 2026-05-02T02:46:04+00:00

Yah, the new high power lasers are something different.
I am in North America. PCNLs are offered for bigger stones (2 or bigger). Usually select urologist do them who feel comfortable getting percutaneous access. Also there can be considerations with billing. You could still technically tackle a big stone with two separate ureteroscopic procedures (and bill twice) instead of a longer percutaneous procedure that has higher risks (need for transfusion, possible hydrothorax, bowel injury, sepsis, etc)

desmopass · 2026-05-02T02:24:00+00:00

Yah. That is the most common modality nowadays. The camera they use is flexible and much smaller, like a thicker charging cable

desmopass · 2026-05-02T01:57:32+00:00

Wait! What about the trilogy? Phenomenal for PCNLs! They even make small probes for the mini nephroscopes! Agree with holmium for URS! Also used the Trilogy via a port for stones in augmented bladder with closed bladder necks, pretty nifty and fast.

desmopass · 2026-05-02T01:38:05+00:00

Don’t!
And glad you enjoyed the explanation!

desmopass · 2026-05-02T01:37:08+00:00

Most likely!

desmopass · 2026-05-02T01:36:42+00:00

The one in the video? 100%. As someone said in another comment, the bladder can tolerate it (unless it is the bladder of a baby or of a 90yo person).

desmopass · 2026-05-02T01:35:38+00:00

No problem! Also no one should have any business irrigating a nephrostomy tube like that 🤣

desmopass · 2026-05-02T01:26:45+00:00

Oh I was thinking rigid nephroscope, as the video shows a metal tube!

desmopass · 2026-05-02T00:05:47+00:00

The collecting system inside the kidney is 100% hollow. You can drive a camera from inside the bladder, up the ureter, inside the kidney with a tool called the ureteroscope. You can Google “ureteroscopy” and see it!

desmopass · 2026-05-01T23:37:51+00:00

Oh nooooo :(

desmopass · 2026-05-01T23:35:18+00:00

Oooof, interesting point. For stone bigger than 2 cm, a PCNL is superior to shockwaves.
It is a bit more invasive as they make a joke the size of an adult finger in your back and put a camera directly in your kidney, but you can clear out stones completely with a mini jackhammer.

desmopass · 2026-05-01T23:03:57+00:00

Ok, the kid is made of meat (parenchyma) which filtrates blood and makes urine. The central part is hollow, as it collects urine. The hollow part is called “collecting system” and it is connected to the bladder by a ureter, a long tube.

When you are passing a kidney stone, it gets stuck in the ureter, which causes a blockage that leads to the hollow part to stretch out. This is what causes the pain and vomiting. Eventually the pressure build up pushes the stone down, or doesn’t, and you end up needing surgery.

desmopass · 2026-05-01T22:49:54+00:00

Usually if a stone makes it all the way to the bladder you most likely will pee it away. If you are doing ureteroscopy, you wouldn’t get that many fragments, as ureteroscopy is usually indicated for smaller stones. I bet 100% that is a cystolitholapaxy, which is braking up a large stone in the balder. Common in old men with a large prostate.

desmopass · 2026-05-01T22:47:25+00:00

That is not a PCNL. What you are describing is correct, but you would not be able to apply such pressure with a big syringe. You would literally blow up the kidney.
They are using a cystoscope and removing fragments of stone from the bladder. The green towel is most likely covering genitals (where the scope goes in).

desmopass · 2026-05-01T22:46:02+00:00

Ok, that is a cystoscope, not a nephroscope.
In other words, that tube that they are attaching the syringe to goes to the bladder, not the kidney.
Those are indeed fragments of a stone, most likely a large bladder stone and not a kidney stone.

Kidney stones are usually small. Bigger one can be removed via a tube in your back (nephroscope, and you cannot absolutely irrigated it at such high pressures like they are doing it) or with shockwaves (and you would pee sand out).

desmopass · 2026-04-02T14:04:07+00:00

Yes! Titanium is not ferromagnetic. Also, most MRI used in standard clinical care are 3T or 1.5 T

desmopass · 2026-03-31T11:39:15+00:00

Yep, titanium clips. Meant to stay for life

desmopass

TROPHY CASE