, Volume 44, Issue 4, pp 345–352 | Cite as

Laparoscopy assisted percutaneous stone surgery can be performed in multiple ways for pelvic ectopic kidneys

  • Haluk SoylemezEmail author
  • Necmettin Penbegül
  • Mehmet Mazhar Utangac
  • Onur Dede
  • Süleyman Çakmakçı
  • Namık Kemal Hatipoglu
Original Paper


Pelvic kidney stones remain a unique challenge to the endourologists. Treatment options include open surgery, extracorporeal shockwave lithotripsy, percutaneous nephrolithotomy (PNL), retrograde intrarenal surgery, and laparoscopy assisted PNL (LA-PNL). As a minimal invasive option, LA-PNL can decrease the risk for bowel and major vessel injury. Here, we describe our experience using the LA-PNL procedures with different combinations, to treat kidney stones in multiple patients with a pelvic ectopic kidney (PEK). Eight patients, with PEK, kidney stones, and no other treatment choice, but open surgery, were included in the study. Two different laparoscopic techniques such as mesocolon dissection and transmesocolic, and four different percutaneous procedures such as standard-PNL, mini-PNL, micro-PNL, and a PNL through the renal pelvis were used for stone extraction in these patients. The mean age of patients was 25.6 ± 12.9 years and mean stone size was 524.1 ± 430.3 mm2. Mean operation time was 150.5 ± 40.0 (77–210) min which was composed of retrograde catheterization (14.8 ± 2.9 min), laparoscopic procedure (48.7 ± 20.6 min) and PNL procedure (86.8 ± 31.1 min). Residual stones were seen in two patients (no additional treatment was need), while a ‘stone-free’ procedure was achieved in six patients (75.0 %). On the post-operative first month visit, a stone was observed on radiological examinations in only one patient (87.5 % stone-free). Mean hospitalization time was 2.8 ± 0.9 days. No perioperative or post-operative complication was observed in all patients. LA-PNL surgery is a safe and effective option for treatment of PEK stones, and has several alternative approaches.


Laparoscopy Percutaneous nephrolithotomy Pelvic ectopic kidney Urolithiasis 


Compliance with ethical standards

Conflict of interest



  1. 1.
    Lang EK (1987) Percutaneous nephrostolithotomy and lithotripsy: a multi-institutional survey of complications. Radiology 162(1 Pt 1):25–30CrossRefPubMedGoogle Scholar
  2. 2.
    Michel MS, Trojan L, Rassweiler JJ (2007) Complications in percutaneous nephrolithotomy. Eur Urol 51(4):899–906. doi: 10.1016/j.eururo.2006.10.020 (discussion 906) CrossRefPubMedGoogle Scholar
  3. 3.
    Rudnick DM, Stoller ML (1999) Complications of percutaneous nephrostolithotomy. Can J Urol 6(5):872–875PubMedGoogle Scholar
  4. 4.
    Desai MR, Jasani A (2000) Percutaneous nephrolithotripsy in ectopic kidneys. J Endourol 14(3):289–292CrossRefPubMedGoogle Scholar
  5. 5.
    Goel R, Yadav R, Gupta NP, Aron M (2006) Laparoscopic assisted percutaneous nephrolithotomy (PCNL) in ectopic kidneys: two different techniques. Int Urol Nephrol 38(1):75–78. doi: 10.1007/s11255-005-3611-9 CrossRefPubMedGoogle Scholar
  6. 6.
    Desai MR, Sharma R, Mishra S, Sabnis RB, Stief C, Bader M (2011) Single-step percutaneous nephrolithotomy (microperc): the initial clinical report. J Urol 186(1):140–145. doi: 10.1016/j.juro.2011.03.029 CrossRefPubMedGoogle Scholar
  7. 7.
    Matlaga BR, Kim SC, Watkins SL, Kuo RL, Munch LC, Lingeman JE (2006) Percutaneous nephrolithotomy for ectopic kidneys: over, around, or through. Urology 67(3):513–517. doi: 10.1016/j.urology.2005.09.056 CrossRefPubMedGoogle Scholar
  8. 8.
    Weizer AZ, Springhart WP, Ekeruo WO, Matlaga BR, Tan YH, Assimos DG, Preminger GM (2005) Ureteroscopic management of renal calculi in anomalous kidneys. Urology 65(2):265–269. doi: 10.1016/j.urology.2004.09.055 CrossRefPubMedGoogle Scholar
  9. 9.
    Ugurlu IM, Akman T, Binbay M, Tekinarslan E, Yazici O, Akbulut MF, Ozgor F, Muslumanoglu AY (2015) Outcomes of retrograde flexible ureteroscopy and laser lithotripsy for stone disease in patients with anomalous kidneys. Urolithiasis 43(1):77–82. doi: 10.1007/s00240-014-0713-9 CrossRefPubMedGoogle Scholar
  10. 10.
    Cinman NM, Okeke Z, Smith AD (2007) Pelvic kidney: associated diseases and treatment. J Endourol Endourol Soc 21(8):836–842. doi: 10.1089/end.2007.9945 CrossRefGoogle Scholar
  11. 11.
    Eshghi AM, Roth JS, Smith AD (1985) Percutaneous transperitoneal approach to a pelvic kidney for endourological removal of staghorn calculus. J Urol 134(3):525–527PubMedGoogle Scholar
  12. 12.
    Holman E, Toth C (1998) Laparoscopically assisted percutaneous transperitoneal nephrolithotomy in pelvic dystopic kidneys: experience in 15 successful cases. J Laparoendosc Adv Surg Tech Part A 8(6):431–435CrossRefGoogle Scholar
  13. 13.
    Basal S, Ozgok Y, Tahmaz L, Atim A, Zor M, Bilgic S, Istanbulluoglu O (2011) Extraperitoneal laparoscopy-assisted percutaneous nephrolithotomy in a patient with osteogenesis imperfecta. Urol Res 39(1):73–76. doi: 10.1007/s00240-010-0263-8 CrossRefPubMedGoogle Scholar
  14. 14.
    Tepeler A, Silay MS, Armagan A, Basibuyuk I, Akman T, Akcay M, Onol SY (2013) Laparoscopic-assisted “microperc” of a stone in a pelvic kidney of a 3-year-old girl. J Laparoendosc Adv Surg Tech Part A 23(2):174–176. doi: 10.1089/lap.2012.0270 CrossRefGoogle Scholar
  15. 15.
    Zafar FS, Lingeman JE (1996) Value of laparoscopy in the management of calculi complicating renal malformations. J Endourol Endourol Soc 10(4):379–383CrossRefGoogle Scholar
  16. 16.
    Troxel SA, Low RK, Das S (2002) Extraperitoneal laparoscopy-assisted percutaneous nephrolithotomy in a left pelvic kidney. J Endourol Endourol Soc 16(9):655–657. doi: 10.1089/089277902761402998 CrossRefGoogle Scholar
  17. 17.
    Otano N, Jairath A, Mishra S, Ganpule A, Sabnis R, Desai M (2015) Percutaneous nephrolithotomy in pelvic kidneys: is the ultrasound-guided puncture safe? Urology 85(1):55–58. doi: 10.1016/j.urology.2014.08.015 CrossRefPubMedGoogle Scholar
  18. 18.
    El-Kappany HA, El-Nahas AR, Shoma AM, El-Tabey NA, Eraky I, El-Kenawy MR (2007) Combination of laparoscopy and nephroscopy for treatment of stones in pelvic ectopic kidneys. J Endourol Endourol Soc 21(10):1131–1136. doi: 10.1089/end.2007.9930 CrossRefGoogle Scholar
  19. 19.
    Tahmaz L, Ozgok Y, Zor M, Basal S, Kilciler M, Istanbulluoglu O, Dayanc M (2009) Laparoscopy-assisted tubeless percutaneous nephrolithotomy in previously operated ectopic pelvic kidney with fragmented J–J stent. Urol Res 37(5):257–260. doi: 10.1007/s00240-009-0205-5 CrossRefPubMedGoogle Scholar
  20. 20.
    Mehmet RM, Rustu YF, Hanefi B, Mursel D, Fusun A, Mehmet I (2013) Direct pelvic access percutaneous nephrolithotomy in management of ectopic kidney stone: a case report and literature review. Ren Fail 35(10):1440–1444. doi: 10.3109/0886022x.2013.828357 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Haluk Soylemez
    • 1
    Email author
  • Necmettin Penbegül
    • 2
  • Mehmet Mazhar Utangac
    • 2
  • Onur Dede
    • 2
  • Süleyman Çakmakçı
    • 2
  • Namık Kemal Hatipoglu
    • 2
  1. 1.Department of Urology, Medical FacultyHacettepe UniversityAnkaraTurkey
  2. 2.Department of Urology, Medical FacultyDicle UniversityDiyarbakirTurkey

Personalised recommendations