PURPOSE: To design a simple, cost-effective system for gaining rapid and accurate calyceal access during percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: The design consists of a low-cost, light-weight, portable mechanical gantry with a needle guiding device. Using C-arm fluoroscopy, two images of the contrast-filled renal collecting system are obtained: at 0-degrees (perpendicular to the kidney) and 20-degrees. These images are relayed to a laptop computer containing the software and graphic user interface for selecting the targeted calyx. The software provides numerical settings for the 3 axes of the gantry, which are used to position the needle guiding device. The needle is advanced through the guide to the depth calculated by the software, thus puncturing the targeted calyx. Testing of the system was performed on 2 target types: 1) radiolucent plastic tubes the approximate size of a renal calyx (5 or 10 mm in diameter, 30 mm in length); and 2) foam-occluded, contrast-filled porcine kidneys. RESULTS: Tests using target type 1 with 10 mm diameter (n = 14) and 5 mm diameter (n = 7) tubes resulted in a 100% targeting success rate, with a mean procedure duration of 10 minutes. Tests using target type 2 (n = 2) were both successful, with accurate puncturing of the selected renal calyx, and a mean procedure duration of 15 minutes. CONCLUSIONS: The mechanical gantry system described in this paper is low-cost, portable, light-weight, and simple to set up and operate. C-arm fluoroscopy is limited to two images, thus reducing radiation exposure significantly. Testing of the system showed an extremely high degree of accuracy in gaining precise access to a targeted renal calyx.

Donor nephrectomy with laparo-endoscopic single site (LESS) surgery has been reported via the transperitoneal approach. We describe a novel technique of retroperitoneal donor nephrectomy using a single surgical incision in the groin, below the abdominal skin crease or "bikini line". The LESS groin incision offers superior cosmesis, while the retroperitoneal approach has distinct advantages, such as the ability to identify the renal vessels early. The new procedure has been performed in two obese patients (body mass index 32 and 33 kg/m2, respectively). The operative times were 4 and 5 hours, warm ischemic times 135 and 315 seconds, blood loss 100 and 250 mL, and hospitalization 3 and 2 days, respectively. Retroperitoneal LESS donor nephrectomy through a single, inconspicuous groin incision is feasible and safe. Further evaluation of the technique in a larger patient cohort is indicated.

A detailed hydrographic and biological survey was conducted in the region of the Subtropical Convergence in the Indian sector of the Southern Ocean in April 2007. Hydrographic data revealed that the subsurface expression of the Subtropical Convergence (at 200 m), marked by the 10°C isotherm, appeared to meander considerably between 41°S and 42°15'S. Total surface chlorophyll-a concentration was low and ranged from 0.03 to 0.42 μg l-1 and was always dominated by the pico- (<2 μm) and nano-(2-120 μm) size classes, which contributed between 81% and 93% of the total pigment. The total chlorophyll-a integrated over the top 150 m of the water column showed no distinct spatial trends, and ranged from 12.8 to 40.1 mg chl-a m². There were no significant correlations between the total integrated chlorophyll-a concentration and temperature and salinity (P > 0.05). The Zooplankton community was dominated, numerically and by biomass, by mesozooplankton comprising mainly copepods of the genera, Oithona, Paraeuchaeta, Pleuromamma, Calanus and Clausocalanus. An exception was recorded at those stations in the region of the front where the tunicate, Salpa thompsoni, dominated the total Zooplankton biomass.