V11-14: Nephrolithotomy Performed With Laparoendoscopic Single-Site Pyeloplasty
VideoIntroductions and Objectives
Laparoendoscopic single site surgery (LESS) for pyeloplasty was introduced to our department from 2008, and we reported the results of LESS pyeloplasty in AUA 2012. We report 5 cases of lithotomy performed Concurrently through the LESS port in patients with renal stones in the distended renal pelvis.
5 patients with PUJO and renal stones underwent pyelolithotomy performed concurrently with LESS pyeloplasty. LESS port was inserted through a 2.5cm incision. A 2-mm port was added for the left hand and a 5-mm flexible scope was used. After dissection of the PUJ, an incision of about 1cm was made along the presumed transection line of the renal pelvis. The pyelolithotomy was performed using a 24 Fr rigid nephroscope through a LESS port (Figure 1). Dismembered pyeloplasty was performed after extraction of the renal stones was completed. In order to evaluate the pain after operation, we used the "pain face scale".
The mean operation time was 277 minutes (range: 225 to 373) and the mean lithotomy time was 31 minutes (range: 20 to 55). No intraoperative or postoperative complications were observed. For all 5 patients, discharge from the hospital was possible after a mean of 3.4 postoperative days (range: 3 to 4). 4 of the patients became stone-free. In the remaining 1 patient with an ectopic kidney in the pelvis and 15 stones, 2 small stones remained. Postoperative ultrasound revealed that hydronephrosis improved in all patients. In all patients, resolution of the symptoms was confirmed. Their renal function was no problem after operation. Pain face scale demonstrated a minimum level of pain for all cases in 3 days after surgery .All patients made comments about their satisfaction for cosmetic appearance.
LESS nephrolithotomy with pyeloplasty is a safe and effective procedure with good cosmetic result for patients with PUJO and renal stones.