Laparoscopic partial nephrectomy for non-functional lower pole kidney stone.

Abstract

We present a retroperitoneal laparoscopic partial nephrectomy video for a non-functional obstructed lower pole with multiple renal stones. A 41-year-old female was admitted to our urology clinic with left-sided flank pain. The radiologic imaging (CT and IVP) revealed multiple left renal stones localized in the pelvis, middle and lower calyces. We performed percutaneous nephrolithotomy and roboflex assisted flexible ureterorenoscopy twice in two months resulting in removal of most of the stone load. Left kidney function on scintigraphy was 20%. Ultrasonography and computerized tomography of the abdomen revealed multiple left lower pole renal stones with a severely dilated lower calyx. The pyelography showed no connection between the collecting system and this non-functional calyceal system due to the high stone load. We performed a laparoscopic retroperitoneal three-port partial nephrectomy with stone extraction. The operative time was 59 minutes. The patient was discharged on day five without complications. Histopathology revealed atrophic renal parenchyma without any malignancy. Laparoscopic retroperitoneal partial nephrectomy might be a safe and an effective method in a non-functional lower pole calyx with a high stone load.