To improve the safety of tubeless percutaneous nephrolithotomy by using a kind of innovative hemostatic sheath to electrocoagulate the bleeding in the percutaneous renal channel.

The clinical data of 586 patients with tubeless percutaneous nephrolithotomy from July 2015 to June 2020 were retrospectively analyzed. After finishing the process of percutaneous nephrolithotomy, the self-designed innovative hemostatic sheath was used to electrocoagulate the bleeding found in the percutaneous renal channel by routine check. The operation time, hemostasis time, decrease of hemoglobin after operation, blood transfusion rate and renal artery embolism ratio were analyzed.

In 586 cases of tubeless percutaneous nephrolithotomy, 103 cases were found to have obvious bleeding in the percutaneous renal channel. The self-designed innovative hemostatic sheath was used to electrocoagulate the bleeding and no nephrostomy tube was left. The operation time of percutaneous nephrolithotomy was 53-105 minutes and the hemostasis time was 7-19 minutes. After operation, hemoglobin decreased 7-21g/L(average 14 g/L) on the next day and decreased 11-32 g/L(average 19 g/L) 2 days later. No blood transfusion or renal artery embolism occurred. The stone removal rate was 94.5%(554/586) 2 weeks after operation. There were 2 cases of renal subcapsular hematoma and 6 cases of pleural effusion, all cured by conservative treatment.

Routine channel examination and electrocoagulation by innovative hemostatic sheath can reduce postoperative bleeding, blood transfusion and renal artery embolism, and improve the safety of tubeless percutaneous nephrolithotomy.