腹腔镜肾盂切开取石术左旋转肾异位

Laparoscopic Pyelolithotomy of Left Ectopic Malrotated Kidney by Dr P P Singh

                               
登录/注册后可看大图

Laparoscopic Pyelolithotomy of left ectopic malrotated kidney (reverse rotation).

History of patient - 23 years old female presented to us with history of pain lower abdomen since 6 months.

In investigations - Blood biochemistry - WNL
Urine rutine microscopic hematuria.
Ultrasound ectopic left pelvic kidney with renal stone of 2.2 x 2.0cm.

PRE Operative IVP

Showing Renal vein and kidney stone.

Showing Ureter.

Renal Vessels, pelvis and ureter.

Dissection of renal vein.

Stone extraction.

Stenting.

Post operative KUB.

Follow Up - Excessive drain for x2 days.
Drain removed after 5 days.
Stent removed after 3 weeks.
Asymptomatic at present.
Follow up ultrasound no residual stone or hydronephrosis.

Renal anomalies are usually at a higher risk of stone formation due to non-dependant drainage in most of the cases.
The first report of laparoscopic pyelolithotomy for calculus removal in a pelvic kidney was reported by william et al in 1996.
SWL or ureteroscopy remain first line therapy for smaller calculi (less than 2cm), while laparoscopic-assisted percutaneous, pure laparoscopic, or open procedures are reserved for larger calculi.
Laparoscopic pyelolithotomy is an effective treatment option for management of stones in the pelvis of an ectopic pelvic kideny.
the patient experienced minimal pain and a brief hospitalization, findings consistent with previous reports of laparoscopic pyelolithotomy for a normally positioned kidney.