Laparoscopically Assisted Percutaneous Transperitoneal Nephrolithotomy in Pelvic Dystopic Kidneys: Experience in 15 Successful Cases

ABSTRACT

The stone-holding pelvic dystopic kidneys of 15 patients were treated with laparoscopically assisted percutaneous transperitoneal nephrolithotomy. With patients in the Trendelenburg position under laparoscopic control, the bowels were dislodged with forceps until the kidney became visible. Under simultaneous laparoscopic and fluoroscopic control, the nephrostomy track was created on the antegrade route using telescopic metal dilators and a rigid nephroscope. Percutaneous nephrolithotomy was carried out in the usual manner. All the stones could be removed successfully. The only minor complication was a delayed urine leakage through the abdominal drain in a patient with a double J stent. Severe complications did not occur. The average operating time was 55 (40–85) minutes; the average hospital stay was 4.8 (4–11) days. On the basis of the authors' experience and a literature review of cases of failed shock wave lithotripsy—which is quite frequently unsuccessful in these cases—and cases of large, dense stones, this method appears to be the simplest and most suitable minimally invasive treatment of the stone-holding pelvic dystopic kidney.