LAPAROSCOPIC TRANSMESOCOLIC PYELOLITHOTOMY FOR PELVIC KIDNEY LITHIASIS - A CASE REPORT

Abstract

The stone disease in a pelvic kidney is often difficult to treat due to the multiple anatomical anomalies. We have performed a laparoscopic pyelolithotomy for a large pelvic kidney stone with guided intraoperative flexible ureteroscopy. We have successfully performed a peritoneal transmesocolic laparoscopic pyelolitotomy to a 35-year old female patient with a 23 mm stone located in the collecting system of her right pelvic kidney. During the operation we also used a flexible ureteroscope to identify the stone due to an aberrant disposition of the right collecting system. Operative time was of 5 hours with no injury of major blood vessels. Postoperative recovery was four days with minimal abdominal pain, minimal abdominal drainage, no urine leakage in the peritoneal cavity and fast retrieval of gastrointestinal function. At this point the patient is stone free and the kidney has normal function demonstrated in a renal scintigraphy. Laparoscopic pyelolithotomy is a safe and efficient treatment option for stone disease with large calculi in ectopic pelvic kidney. The advantage of laparoscopic pyelolithotomy is that it has good functional results, with fast postoperative recovery, low complication rates and high stone free rate in one session.