Robotic extended pyelolithotomy for treatment of renal calculi: A feasibility study

Hospital Kuala Lumpur, Kuala Lumpor, Kuala Lumpur, Malaysia
World Journal of Urology (Impact Factor: 2.67). 07/2006; 24(2):198-201. DOI: 10.1007/s00345-006-0099-6
Source: PubMed


Percutaneous nephrolithotomy (PCNL) remains the treatment of choice for staghorn renal calculi. Many reports suggest that laparoscopy can be an alternative treatment for large renal stones. We wished to evaluate the role and feasibility of laparoscopic extended pyelolithotomy (REP) for treatment of staghorn calculi. Thirteen patients underwent REP for treatment of staghorn calculi over a 12-day period. Twelve patients had partial staghorn stones and one had a complete staghorn stone. All patients had pre-operative and post-operative imaging including KUB and computed tomography. All procedures were completed robotically without conversion to laparoscopy or open surgery. Mean operative time was 158 min and mean robotic console time was 108 min. Complete stone removal was accomplished in all patients except the one with a complete staghorn calculus. Estimated blood loss was 100 cc, and no patient required post-operative transfusion. REP is an effective treatment alternative to PCNL in some patients with staghorn calculi. However, patients with complete staghorn stones are not suitable candidates for this particular technique.

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Available from: James O Peabody, Jun 22, 2014
    • "Percutaneous nephrolithotomy is the current treatment of choice for large renal stones but robot-assisted extended pyelolithotomy (REP) provides an appealing option in cases of staghorn calculi and in patients undergoing concurrent RAP.[42–43] Hemal and coworkers found that in six patients who underwent REP or robot assisted pyelolithotomy, the mean operative time was 106 minutes and EBL was less than 50 ml in all cases. [44] One patient required conversion to an open procedure because the renal calculus could not be localised. "
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