Introduction: we present a video of how a difficult situation was resolved by on the spot improvisation of a basket made form a standard Nitinol hydrophilic guidewire, to extract a lateral stone, during percutaneous renal surgery. Are there other alternatives materials to improvise a basket? Is it possible to improvise a basket from 2/0 nylon suture? we present ideas of how to do it. Then it is tried in our endoscopic glove model. Methods: Improvisation of a Nitinol basket: The floppy tip of a standard hydrophilic guidewire is looped twice, forming a 3 cm diameter loop. The distal ends of the loops are placed crosswise. They are fixed in this position with knots. The guidewire tail is back-loaded into the operating channel of the nephroscope until the proximal knot is introduced into the operating channel. The whole complex nephroscope-basket is moved as one in order to maneuver and catch the stone. After introduction through the Amplatz sheath, and into the calyx, the basket is moved around until the stone is caught and attracted through the Amplatz sheath. Improvisation of the nylon basket: The tip of the 2/0 nylon suture is looped twice, forming a 3 cm diameter loops. The distal ends of the loops are placed crosswise, and fixed with knots. The other end of the nylon suture is passed through the inner catheter of the Coaxial double-J stent pusher. Then, it is fixed to the distal end of the pusher with ligations. Thus, the basket and the inner catheter are forming a unit. The basket is closed or opened by attracting or pushing the inner catheter through the outer one. Endoscopic Glove model: a surgical glove is filled with water and a 24 Amplatz sheath is inserted into its opening and fixed with ligations. Stones are inserted into the glove. The basket is tried through the nephroscope. Results: it is possible to improvise a basket, from a Nitinol guidewire, or from a 2/0 nylon suture and a coaxial double-J stent pusher, to use through the nephroscope. It was easy and quick to make. These baskets have been tried successfully in PCNL. The guidewire basket was successfully used in 2 patients, when the nitinol basket was not available. The nylon basket was effective to mobilize and extract the stones, in the glove model. It was also successfully tried in a PCNL case. Conclusions: to improvise an on the spot handmade basket, form a guidewire or a Nylon suture is possible and easy to prepare. This idea to improvise an on the spot handmade basket had allowed to solve an intraoperative problem or complication. To overcome different situations during percutaneous renal surgery a spirit of innovation can be helpful. SOURCE OF Funding: None
