{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T14:48:58Z","timestamp":1774882138667,"version":"3.50.1"},"reference-count":16,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T00:00:00Z","timestamp":1774828800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the value of intraoperative multimodal localization strategies in managing non-communicating calyceal diverticulum stones without preoperative definitive diagnosis in a single clinical case.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A 48-year-old female with a history of open renal stone surgery and cesarean section was enrolled in this single case study. Preoperative CT revealed a calcified lesion (1.5\u2009\u00d7\u20091.2\u2005cm, CT value 1,235 HU) at the right upper renal pole but failed to identify the diverticular structure. Intraoperative exploration identified a ureteral orifice ectopically located on the right posterior bladder wall (23\u2005mm deviation from midline). An innovative \u201cthree-step localization protocol\u201d was implemented: 1. CT-anatomical landmark spatial co-registration, 2. Guidewire advancement with tactile feedback validation, 3. Real-time ultrasonographic confirmation of guidewire tip positioning. A 10\/12Fr ureteral access sheath was pre-placed in the right ureter to establish a stable operative channel, facilitate irrigation and suction, and reduce ureteral mucosal injury during the surgical procedure. Diverticular neck incision was performed using holmium laser (200\u2005\u03bcm fiber, 0.8J\/20\u2005Hz) for channel creation, followed by stone fragmentation under negative-pressure suction system guidance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The procedure was completed in 90\u2005min with negligible blood loss (&amp;lt;10\u2005mL). Intraoperative ultrasonography confirmed complete stone clearance. No postoperative complications or recurrence was observed during follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Multimodal localization technique achieved effective and precise surgical navigation for the non-communicating calyceal diverticulum in this single case. This approach combines the advantages of natural orifice preservation with controlled infection risk and minimized hemorrhagic complications, and may provide a valuable clinical and technical reference for cases with atypical anatomy and inconclusive preoperative imaging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1799215","type":"journal-article","created":{"date-parts":[[2026,3,30]],"date-time":"2026-03-30T13:54:21Z","timestamp":1774878861000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical exploration of flexible ureteroscopy combined with holmium laser and intraoperative ultrasound localization for the treatment of stones in non-communicating calyceal diverticula: a single case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Qiang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaopeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Wannan Medical College","place":["Wuhu, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Houbao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Urology, The First Affiliated Hospital of Wannan Medical College","place":["Wuhu, 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