V10-14: Robotic Nephrolithotomy: Various Techniques for Extraction

Video

Introductions and Objectives
Percutaneous nephrolithotomy (PCNL) is the current gold standard for staghorn and large renal pelvis (>2cm) calculi. Robotic nephrolithotomy is an alternative option in patients with additional pathology precluding PCNL and in those where primary PCNL fails. We utilized Firefly® technology to assist in removal of large renal calculi in patients who had failed PCNL or had additional pathology.

Methods
Robotic assisted nephrolithotomy was performed on 3 patients using various minimally invasive stone extraction techniques. This includes use of Firefly® technology in combination with antegrade ureteroscopy.

Results
A total of 3 patients underwent robotic-assisted nephrolithomy with stone free rates of 100%. In all 3 procedures Firefly® technology was utilized via ureteroscopy to guide to the exact location of the stone. Two patients had failed PCNL. In another patient, a large cyst decortication followed by stone removal was performed. All patients were discharged on post-operative day 1 with an indwelling JJ stent. No patient was readmitted within 30 days and there were no perioperative complications.

Conclusions
Robotic-assisted nephrolithotomy is an attractive option for large renal stones in patients that either fail primary PCNL or if additional pathology exists that precludes PCNL. Stone free rates are high with low morbidity and quick recovery.

Funding: none