{"title":"同时进行的双侧腹腔镜肾盂切开术:三例患者的病例系列","authors":"Rudramani, Sunil Kumar Singh, Anamika Chandra, Vikas Singh","doi":"10.1007/s12262-024-04106-w","DOIUrl":null,"url":null,"abstract":"<p>Several patients present with bilateral renal and ureteric stones with or without hydronephrosis and preserved renal functions. Simultaneous bilateral laparoscopic pyelolithotomy (SBLP) is hitherto, not performed and patients are operated metachronously. Here, we report 3 cases of transperitoneal SBLP in adult and paediatric patients. A 30-year-old gentleman had a recurrent large pelvic stone in the left kidney and a small one in the right; a 40-year-old man had left solitary pelvic calculus with small lower calyceal calculus and broken calcified stent parts in the renal pelvis and upper ureter on the other side. An 8-year-old boy had bilateral solitary renal pelvic stone. All 3 subjects had preserved calyces, mild hydronephrosis, moderate size extra-renal pelvis and preserved renal functions. SBLP under general anaesthesia was performed. Meticulous pyelotomy closure was done using Polygalactin suture 3–0 with intra-corporeal suturing after DJ stent insertion. Single abdominal drain FG 20 was placed in the pelvis in all subjects. Two out of three patients underwent successful removal of all stones on both sides. In the third patient (40-year man), multiple small calculi (< 5 mm) in the left kidney were left behind and the part of calcified broken stent was removed using a ureteroscope. The operative time was 2 h and 25 min on an average in these cases. The blood loss was minimal on an average less than 50 ml. The 3 illustrative cases have paved the path and the confidence to undertake simultaneous bilateral laparoscopic pyelolithotomy and uretero-lithotomy more frequently in other units at our institute. Laparoscopic nephrolithotomy in intra-renal pelvis may be more difficult and is being attempted in single side stones. To start with SBLP may be tried in extra-renal pelvic stones. Second side should only be proceeded on after timely and successful completion on one side.</p>","PeriodicalId":13391,"journal":{"name":"Indian Journal of Surgery","volume":null,"pages":null},"PeriodicalIF":0.4000,"publicationDate":"2024-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Simultaneous Bilateral Laparoscopic Pyelolithotomy: a Case Series of Three Patients\",\"authors\":\"Rudramani, Sunil Kumar Singh, Anamika Chandra, Vikas Singh\",\"doi\":\"10.1007/s12262-024-04106-w\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Several patients present with bilateral renal and ureteric stones with or without hydronephrosis and preserved renal functions. Simultaneous bilateral laparoscopic pyelolithotomy (SBLP) is hitherto, not performed and patients are operated metachronously. Here, we report 3 cases of transperitoneal SBLP in adult and paediatric patients. A 30-year-old gentleman had a recurrent large pelvic stone in the left kidney and a small one in the right; a 40-year-old man had left solitary pelvic calculus with small lower calyceal calculus and broken calcified stent parts in the renal pelvis and upper ureter on the other side. An 8-year-old boy had bilateral solitary renal pelvic stone. All 3 subjects had preserved calyces, mild hydronephrosis, moderate size extra-renal pelvis and preserved renal functions. SBLP under general anaesthesia was performed. Meticulous pyelotomy closure was done using Polygalactin suture 3–0 with intra-corporeal suturing after DJ stent insertion. Single abdominal drain FG 20 was placed in the pelvis in all subjects. Two out of three patients underwent successful removal of all stones on both sides. In the third patient (40-year man), multiple small calculi (< 5 mm) in the left kidney were left behind and the part of calcified broken stent was removed using a ureteroscope. The operative time was 2 h and 25 min on an average in these cases. The blood loss was minimal on an average less than 50 ml. The 3 illustrative cases have paved the path and the confidence to undertake simultaneous bilateral laparoscopic pyelolithotomy and uretero-lithotomy more frequently in other units at our institute. Laparoscopic nephrolithotomy in intra-renal pelvis may be more difficult and is being attempted in single side stones. To start with SBLP may be tried in extra-renal pelvic stones. Second side should only be proceeded on after timely and successful completion on one side.</p>\",\"PeriodicalId\":13391,\"journal\":{\"name\":\"Indian Journal of Surgery\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.4000,\"publicationDate\":\"2024-06-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Indian Journal of Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12262-024-04106-w\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12262-024-04106-w","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
Simultaneous Bilateral Laparoscopic Pyelolithotomy: a Case Series of Three Patients
Several patients present with bilateral renal and ureteric stones with or without hydronephrosis and preserved renal functions. Simultaneous bilateral laparoscopic pyelolithotomy (SBLP) is hitherto, not performed and patients are operated metachronously. Here, we report 3 cases of transperitoneal SBLP in adult and paediatric patients. A 30-year-old gentleman had a recurrent large pelvic stone in the left kidney and a small one in the right; a 40-year-old man had left solitary pelvic calculus with small lower calyceal calculus and broken calcified stent parts in the renal pelvis and upper ureter on the other side. An 8-year-old boy had bilateral solitary renal pelvic stone. All 3 subjects had preserved calyces, mild hydronephrosis, moderate size extra-renal pelvis and preserved renal functions. SBLP under general anaesthesia was performed. Meticulous pyelotomy closure was done using Polygalactin suture 3–0 with intra-corporeal suturing after DJ stent insertion. Single abdominal drain FG 20 was placed in the pelvis in all subjects. Two out of three patients underwent successful removal of all stones on both sides. In the third patient (40-year man), multiple small calculi (< 5 mm) in the left kidney were left behind and the part of calcified broken stent was removed using a ureteroscope. The operative time was 2 h and 25 min on an average in these cases. The blood loss was minimal on an average less than 50 ml. The 3 illustrative cases have paved the path and the confidence to undertake simultaneous bilateral laparoscopic pyelolithotomy and uretero-lithotomy more frequently in other units at our institute. Laparoscopic nephrolithotomy in intra-renal pelvis may be more difficult and is being attempted in single side stones. To start with SBLP may be tried in extra-renal pelvic stones. Second side should only be proceeded on after timely and successful completion on one side.
期刊介绍:
The Indian Journal of Surgery is the official publication of the Association of Surgeons of India that considers for publication articles in all fields of surgery. Issues are published bimonthly in the months of February, April, June, August, October and December.
The journal publishes Original article, Point of technique, Review article, Case report, Letter to editor, Teachers and surgeons from the past - A short (up to 500 words) bio sketch of a revered teacher or surgeon whom you hold in esteem and Images in surgery, surgical pathology, and surgical radiology.
A trusted resource for peer-reviewed coverage of all types of surgery
Provides a forum for surgeons in India and abroad to exchange ideas and advance the art of surgery
The official publication of the Association of Surgeons of India
92% of authors who answered a survey reported that they would definitely publish or probably publish in the journal again
The Indian Journal of Surgery offers peer-reviewed coverage of all types of surgery. The Journal publishes Original articles, Points of technique, Review articles, Case reports, Letters, Images and brief biographies of influential teachers and surgeons.
The Journal spans General Surgery, Pediatric Surgery, Neurosurgery, Plastic Surgery, Cardiothoracic Surgery, Vascular Surgery, Rural Surgery, Orthopedic Surgery, Urology, Surgical Oncology, Radiology, Anaesthesia, Trauma Services, Minimal Access Surgery, Endocrine Surgery, GI Surgery, ENT, Colorectal Surgery, surgical practice and research.
The Journal provides a forum for surgeons from India and abroad to exchange ideas, to propagate the advancement of science and the art of surgery and to promote friendship among surgeons in India and abroad. This has been a trusted platform for surgons in communicating up-to-date scientific informeation to the community.