Simultaneous treatment of ureteropelvic junction obstruction complicated by renal calculi with robotic laparoscopic surgery and flexible cystoscope
- 15 Downloads
To present our experience of combining transperitoneal robot-assisted laparoscopic pyeloplasty (RALP) and concomitant flexible cystoscope lithotomy for ureteropelvic junction obstruction (UPJO) complicated by renal caliceal stones in the same session.
Patients and methods
Between October 2014 and November 2017, RALP combined with flexible cystoscope lithotomy was performed in 16 patients with UPJO and ipsilateral renal caliceal stones. Stone location and size were preoperatively assessed. After pyelotomy with appropriate length (about 8–15 mm), a 16F flexible cystoscope through the assistant trocar or robotic trocar was introduced directly into the renal pelvis under laparoscopic vision. Holmium laser lithotripsy and pressure irrigation via a pump were used for caliceal stone removal. Subsequently, robot-assisted laparoscopic pyeloplasty was undergone in a standard fashion.
The calculi sizes ranged from 5 to 34 mm (mean 18.6 mm) and an average of 3.4 stones per patient was removed (range 1–8 stones). Complete stone clearance confirmed by postoperative imaging was achieved in all patients. Mean operative time was 204.6 min and estimated blood loss was 55.6 mL. Mean hospital stay was 6.7 days (3–17). The stent was removed after 8 weeks. No major intraoperative or postoperative complications were noted during a mean follow-up of 10.4 months (range 6–27 months).
RALP combined with flexible cystoscope lithotomy is safe and effective alternatives for the simultaneous management of UPJO complicated by renal caliceal stones.
KeywordsUreteropelvic junction obstruction Renal calculi Robotic surgery Flexible cystoscope
This study is supported by the National Natural Science Foundation of China (No. 81700662), Natural Science Research Project Funding of Higher Education Institutions of Anhui Province (No. KJ2016A349), Junior Research Project Funding of Anhui Natural Science Foundation (No. 1708085QH203).
CY, JZ and ZL contributed to data collection, data analysis and manuscript writing. ZH and JW took part in data collection and management. LZ involved in manuscript editing. CL contributed to project development and manuscript writing.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
The present study was approved by the Ethical Committee the First Affiliated Hospital of Anhui Medical University.
Informed consent was signed by the patients for the publication of related images and this report.
- 19.Chen Z, Zhou P, Yang ZQ, Li Y, Luo YC, He Y, Li NN, Xie CQ, Lai C, Fang XL, Chen X (2013) Transperitoneal mini-laparoscopic pyeloplasty and concomitant ureteroscopy-assisted pyelolithotomy for ureteropelvic junction obstruction complicated by renal caliceal stones. PLoS ONE 8(1):e55026. https://doi.org/10.1371/journal.pone.0055026 (Epub 2013 Jan 9) CrossRefPubMedPubMedCentralGoogle Scholar
- 26.Hanske J, Sanchez A, Schmid M, Meyer CP, Abdollah F, Roghmann F, Feldman AS, Kibel AS, Sammon JD, Noldus J, Trinh QD, Eswara JR (2015) Comparison of 30-day perioperative outcomes in adults undergoing open versus minimally invasive pyeloplasty for ureteropelvic junction obstruction: analysis of 593 patients in a prospective national database. World J Urol 33(12):2107–2113CrossRefGoogle Scholar