Flexible nephroscopy used for renal stone extraction during laparoscopic and robot- assisted pyeloplasty.

Czech version

Authors: Markéta Matějková ¹; Darina Pacigová ¹; Ágnes Juhász ¹; Milan Čermák ¹; Jiří Kočárek ^1,2
Authors‘ workplace: Urologické oddělení, Ústřední vojenská nemocnice - Vojenská fakultní nemocnice Praha 1, 2Urologická klinika, 1. lékařská fakulta, Univerzita Karlova v Praze ¹
Published in: Ces Urol 2017; 21(2): 119-121
Category: Video

Overview

Introduction:
Pyelolithiasis is a common accompanying effect of pyeloureteric junction (PUJ) stenosis. Therefore, it is convenient to treat the stenosis and the lithiasis at the same time. The video shows flexible nephroscopy used for renal stone extraction during laparoscopic and robot-assisted pyeloplasty.

Description of the clinical case:
We present a set of ten patients aged 36–67 indicated for pyeloplasty due to PUJ stenosis whose lithiasis has been proved by ultrasonography, X-rays or CT scan. Intraoperatively, we introduce a flexible cystoscope or nephroscope into one of the surgery ports and we penetrate the hollow part of the kidney through the cut renal pelvis, using irrigation with physiological solution. Under double optic supervision, we then safely and gently extract the concrements even from the lower calices – that are relatively hard to reach due to their anatomy – with the help of Dormia baskets.

Conclusion:
The use of a flexible optic device for nephrolithiasis extraction during laparoscopic and robot-assisted pyeloplasty is a very gentle method that allows extraction of concrements even from the relatively harder to reach calices. It is convenient especially in multiple lithiasis cases.

KEY WORDS:
Pyeloplasty, nephrolithiasis, flexible nephroscopy.

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