The stone-retaining pelvic ectopic kidney of a 46-year-old female was treated with laparoscopically assisted complete supine percutaneous transperitoneal nephrolithotomy. She had a past history of previous open surgery for a left kidney stone about 7 years ago, left transurethral ureterolithotripsy (TUL) about 5 years ago, and an unsuccessful left extracorporeal shock wave lithotripsy (ESWL) recently. Ultrasound and intravenous pyelogram (IVP) imaging showed multiple calculi in a left ectopic pelvic kidney overlying on the sacrum. The burden of stone was 5 cm. With the patient in the supine position under laparoscopic control, the bowels were dislodged with forceps until the kidney became visible. Under laparoscopic control, the nephrostomy track was created on the antegrade route using a one shot dilator. Percutaneous nephrolithotomy was carried out in the usual manner with a rigid 26F nephroscope. Stones were fragmented and removed. No complications occurred. The operating time was 105 minutes; the hospital stay was 4 days. On the basis of the authors' experience, PNL with guided laparoscopy in pelvic kidneys is safe even in reoperative patients.
KEYWORDS: Reoperated pelvic kidney; Complete supine percutaneous transperitoneal nephrolithotomy (PNL); Urolithiasis; Laparoscopic guided PNL; Ectopic kidney
CITATION: UroToday Int J. 2009 Oct;2(5). doi:10.3834/uij.1944-5784.2009.10.06