Laparoscopic assisted percutaneous nephrolithotomy in ectopic pelvic kidneys

Abstract

Three patients underwent laparoscopic assisted percutaneous nephrolithotomy (PNL). A kidneys, ureter and bladder (KUB), and intravenous pyelogram (IVP) of the first patient showed a 3 cm calculus in a right side ectopic pelvic kidney overlying on the sacrum. The second patient had bilateral ectopic kidneys. The right kidney was located in the true pelvis without calculi and the left kidney was located in the iliac cavity with a 2.5 cm calculus in the renal pelvis. The third one had a 4 cm stone in the infundibulum of the upper calyx of the left pelvic ectopic kidney. All of them had a history of failed shock wave lithotripsy after two sessions. Then the patients were scheduled for laparoscopic assisted percutaneous removal of calculi. Under fluoroscopic control the best access route was located and the kidney was punctured. A 24F nephroscope was introduced and all calculi were disintegrated and removed. Operating time was 150, 120 and 110 min in cases 1, 2 and 3, respectively. Complete stone clearance was documented with a plain X-ray KUB film and ultrasonography. Finally the patients underwent IVP three months following the operation. They were all well and there were no early or late complications.