Fluoroscopy-free mini-PCNL using CT–ultrasound fusion guidance in a pediatric patient with recurrent cystine stones: A case report

Pediatric patients are particularly susceptible to ionizing radiation risks. A fluoroscopy-free mini-percutaneous nephrolithotomy (mini-PCNL) was performed using computed tomography (CT)-ultrasound fusion guidance for recurrent cystine nephrolithiasis in a 12-year-old boy. Renal access and complete stone clearance were achieved. Integrating preoperative CT with real-time ultrasonography enabled precise targeting, overcoming limitations of ultrasound-only guidance. The procedure was completed safely, with minimal blood loss and 90-min operative time. CT-ultrasound fusion-guided mini-PCNL is a feasible radiation-sparing approach for pediatric patients with complex renal stones.