This is an unashamedly practical guide to the percutaneous access of the upper tract. Its diminutive size belies the wealth of information contained within. Whilst the text begins traditionally with a chapter on applied anatomy, the remainder reverts to an almost bullet point approach to percutaneous access, PCNL (both routine and complex) and those aspects relating to complications.

For the dedicated stone specialist (perhaps starting in independent practice) there is a useful shopping list of requirements – whether this be medical personnel or equipment. The list is not short and for a department yet to provide a specialist stone service it demonstrates the depth of the investment required to support a fledgling service. Nevertheless it provides a useful check list of requirements in presenting the all important business case. Some of the strongest elements within the book relate to the techniques of percutaneous access whether in discussing parallax, needle placement or positioning. In many ways the book unashamedly demystifies the ‘magic’ of percutaneous access by breaking it down into a series of bite-sized steps designed to be both methodical and reproducible.

More complex aspects of PCNL are covered in the same assured manner highlighting pitfalls for the unwary and the essential ‘get out of jail cards’ for those difficult scenarios. Many with a sub-specialist interest in the field are likely to benefit from an analysis of those more complex scenarios such as calyceal punctures, failures and ‘Y’ puncture techniques. There is curiously no mention of supine PCNL which undoubtedly will diminish its appeal for some but it is more than made up for by a comprehensive approach to the prone approach.

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Tim Lane

East and North Hertfordshire NHS Trust.

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