Robotic pyelolithotomy for a staghorn stone of kidney
The video shows a case of a staghorn stone of the right kidney in a female patient 48 years old.The patient complained of recurrent infections and flank pain.The stone occupied entirely the pelvis and most of the calyces.There was no evidence of ureteropelvic junction obstruction. Two minor calculi were in the mid calyces.
The stone was approched by robotic procedure. The renal pelvis was prepared and opened with V incision. Marked edema and hyperemia were present. The stone filling the entire pelvis and the calyces was dislocated and removed. During maneuver part of stone in the upper calyx ruptured and was removed apart.The operative time was about 120 minutes . The two residual minor calculi were approched in a second time by endourological procedure.
There was no post operative complication.The patient was discharged after two days.Double J was removed at the third month after endoscopic laser lithotripsy of two minor calculi. TC control after three months demonstrated the absence of residual stone and a normal configuration of the urinary tract.
In selected cases of large renal staghorn calculi the robotic surgery is very effective. The specific articulation and the finest movements of the robotic arms allow a complete removal of stone and a precise reconstruction of the urinary tract.