BERKELEY, CA (UroToday.com) - For ectopic kidneys, ureteropelvic junction obstruction and stone formation incidence are higher than in the general population. This is most likely due to abnormal rotation (especially anterior) and anatomy, as well as the aberrant vasculature of these kidneys.
In pelvic kidneys, a conventional PCNL procedure -- prone position and fluoroscopy access -- was not suitable due to bowel and bony pelvis, which were wrapped around the kidney. During PNL access, unusual approaches have been reported by different authors. In the current case, the pelvis of the ectopic kidney was localized anteriorly and both laparoscopy and fluoroscopy provided adequate visualization. Therefore, an “eye of the needle” access technique was used without contrast media, and it was punctured directly into the pelvis. In the supine position, posterior renal artery injury should occur less frequently than in the prone position at direct pelvic puncture, when anatomy is concerned. Also, management of bleeding should not be a problem in pelvic kidney with direct laparoscopic visualization. However, there is no study in the literature comparing supine with prone position for direct pelvis access.
Written by:
Murat Mehmet Rifaioglu, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations etc... of their research by referencing the published abstract.
Mustafa Kemal University Medical Faculty, Urology Department, Serinyol, Hatay, 31100 Turkey
Tubeless percutaneous nephrolithotomy: Yes but when? A multicentre retrospective cohort study - Abstract
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