Extended pyelolithotomy: the use of renal artery clamping and regional hypothermia.

Extended pyelolithotomy is a technique applicable for removal of most staghorn, and large pelvic and caliceal calculi. Nephrotomy incisions can be avoided in many cases. The efficiency of extended pyelolithotomy in difficult cases can be improved by renal artery occlusion combined with regional renal hypothermia. Devascularization of the kidney produces softening of the renal substance, which facilitates stone removal. The operative method is described and 5 cases are presented.