LAPAROSCOPIC MANAGEMENT OF LARGE RENAL CALCULI A CASE SERIES FROM SKIMS MC BEMINA ajazrather1966@gmail.com

 

LAPAROSCOPIC MANAGEMENT OF LARGE RENAL CALCULI A CASE SERIES FROM SKIMS MC BEMINA

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India

Video

The introduction of Endourological Procedures such as PCNL & ESWL have led to the revolution in the management of nephrolithiasis. But in large calculi especially stag horn calculi , laparoscopy has a definite role and in recent years Retroperitoneal Laparoscopic Pyelolithotomy (RPLP) approach has been reported as a feasible alternative in various series.

study was done ,over a period of 1and half years where patients with renal pelvic stone (s) more than 4 cm , were considered for laparoscopic Retroperitoneal Pyelolithotomy (RPLP) Balloon dissection technique was used to develop retroperitoneal space through a10mm port Three ports were used, camera port-10mm and two working ports- 5 mm Stenting was done in all the patient during the surgical procedure.

Total of 10 patients were operated- 8 males & 2 females.,Mean Operative time was 107 minutes (Range 90-125 Minutes, Approximate blood loss was 98.2 ml (average 74-144 ml) , Hospitalization time was between 3 to 5 days. ,Stone clearance was achieved in 9 patients and one patient were converted to open ,One patient developed UTI in post-operative period..There was no Major complication / mortality. One of our patients were converted to open procedure.

RPLP is a promising alternative to open or endo urological options for a large Renal calculus, with encouraging results. It yields high stone-free rates with minimum morbidity ,is a safe and feasible option recommended for the management of large Renal calculi, if proper logistics and expertise is available in a General surgery Unit.

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