Laparoscopic Assisted Percutaneous Nephrolithotomy in Ectopic Pelvic Kidneys

Percutaneous Nephrolithotomy (PCNL) in the ectopic pelvic kidney is highly challenging due to the presence of pelvic bone structures behind the kidneys and intestine loops in the anterior. Therefore, combining PCNL with laparoscopy will help prevent undesirable complications.

This case series was performed on eight patients with pelvic kidneys. Patients became candidates for PCNL, which was performed by an intra-abdominal laparoscopic guide, under fluoroscopic control. The best tract for access to the pyelocaliceal system was obtained and renal stones were completely crushed and removed. The stone clearance status was assessed with a plain X-ray and postoperative ultrasound.

The mean scores of maximum diameter of the stones, duration of the surgery, and hospitalization length were estimated at 23.5 mm, 114 min, and 3.3 days, respectively. There were no major complications during or after the surgery. All eight patients became stone-free and none of them needed to be readmitted.

Laparoscopic-assisted PCNL in ectopic pelvic kidneys is a safe and feasible technique with good results. This combined technique requires sufficient experience and expertise in both laparoscopic and endourologic fields since it has potential side effects of both methods.