I think that it is a good thing to have a safety guidewire and I always recommend its use to my students.

Here are some tricks that I use.

http://youtu.be/t6VNPxNGDdA

is there any one with a comment or another trick?

The safety wire is very important in percutaneous renal surgery and we insert it through a dilation cannula before introduction of the balloon

Thank you for your trick, do you use other tricks, especially one reusing or "recycling"  some item on the operating table.

I don't routinely use a safety guide wire while performing PNL.

Thank you for your comment, and indeed, the safety guidewire is not mandatory. However, I prefer working for with a safety wire:

- I m trying to spread PCNL in my country, so I do a lot of teaching, coaching, workshops... and I want the urologist to have a safety wire at least until they will become expert; with beginners many times we happen to lost the tract and the safety wire is handy.

- even if the tract is lost I think that it is easily recovered by exploration like laparoscopy (I have a video of percutaneous nephropexy, where the nephroscope perform a nephrolysis), or injection of a dye through the ureteral catheter....but I think the recovery is quicker with the safety.

- I don't like to have a guidewire through the sheath.

- the safety wire gives me some quick orientation, especially in difficult cases.

- at the end of the procedure, I like to explore the parenchymal tunnel for very active bleeding, and to explore the calyx of entry for residual stones; so I retrieve the Amplatz sheath outside in this case this wire is helpful.

- I work with a 24 F sheath but sometimes I change it to 30F so a safety wire is handy and gives more confidence.

No, I do not use a safety wire during the PCNL surgery since 2008. In case of the track lost, you may use solutions with dye like methylene blue or rifampin thru the ureteral catheter to find the tract.