Abstract:Objective: We present our experience with using rigid nephroscopy for renal calculi removal during robot-assisted pyeloplasy (RAP) for UPJO. Methods: 17 patients who underwent RAP for UPJO and rigid nephroscopy for renal calculi were enrolled in our study. Their medical records were analysised retrospectively. Results: UPJO were found on dual sides, the left side and the right side in 1, 6 and 7 patients respectively. The average operative time was 180.5 min, which was 40.9 minutes longer than the mean operative time in patients without renal calculi. There was no significant difference in blood loss, hospital stay, complications, and success rates between patients with and without renal calculi. Conclusions: The use of a concomitant rigid nephroscope and RAP is a safe and feasible option for the treatment of UPJO complicated with renal calculi.
[1] Patel M, Porter J. Robotic retroperitoneal surgery: a contemporary review. Curr Opin Urol, 2013,23(1):51-56. [2] 刘驰, 唐波, 郝迎学, 等.达芬奇机器人与腹腔镜胃癌手术近期疗效对照研究.第三军医大学学报,2013,35(11):1164-1166. [3] Braga LH, Pace K, DeMaria J, et al. Systematic review and metaanalysis of robotic-assisted versus conventional laparoscopic pyeloplasty for patients with ureteropelvic junction obstruction: effect on operative time, length of hospital stay, postoperative complications,and success rate. Eur Urol, 2009,56(5):848-857. [4] Nayyar R, Gupta NP, Hemal AK. Robotic management of complicated ureteropelvic junction obstruction. World J Urol, 2010,28(5):599-602. [5] Bachmann A, Ruszat R, Forster T, et al. Retroperitoneoscopic pyeloplasty for ureteropelvic junction obstruction (UPJO):solving the technical difficulties. Eur Urol, 2006,49(2):264-272. [6] Scardino PT, Scardino PL. Obstruction at the ureteropelvic junction. In: Bergman H, ed. The Ureter. 2nd ed. New York: Springer-Verlag, 1981:697,Chapter 33. [7] Agarwal A, Varshney A, Bansal BS. Concomitant percutaneous nephrolithotomy and transperitoneal laparoscopic pyeloplasty for ureteropelvic junction obstruction complicated by stones.J Endourol, 2008,22(10):2251-2255. [8] Michel MS, Trojan L, Rassweiler JJ. Complications in percutaneous nephrolithotomy. Eur Urol, 2007,51(4):899-906; discussion 906. [9] Srivastava A, Singh P, Gupta M, et al. Laparoscopic pyeloplasty with concomitant pyelolithotomyeis it an effective mode of treatment? Urol Int, 2008,80(3):306-309. [10] Moon DA, El-Shazly MA, Chang CM, et al. Laparoscopic pyeloplasty:evolution of a new gold standard. Urology, 2006,67(5):932-936. [11] Nayyar R, Gupta NP, Hemal AK. Robotic management of complicated ureteropelvic junction obstruction. World J Urol, 2010,28(5):599-602. [12] Nayyar R, Singh P, Gupta NP. Robot-assisted laparoscopic pyeloplasty with stone removal in an ectopic pelvic kidney. JSLS, 2010,14(1):130-132. [13] Miernik A, Wilhelm K, Ardelt PU, et al. Standardized flexible ureteroscopic technique to improve stone-free rates. Urology, 2012, 80(6):1198-1202.