LAPAROSCOPIC PYELOLITHOTOMY AND Y-V PYELOPLASTY IN PATIENT WITH LARGE PYELUM CALCULI AND UPJO

Abstract

Objective: We report our experience in laparoscopic pyelolithotomy with Y-V pyeloplasty. Case(s) Presentation: A 35 years old man with a chief complained of right flank pain since 1 year ago and worsened since 3 months before admission. KUB-IVU showed right hydronephrosis, pyelum calculi, and UPJO. We performed Laparoscopic Pyelolithotomy and Y-V Pyeloplasty. Operative time was 180 minutes and blood loss was about 50 cc. Drain was removed at post-operative day 4. Operating wound was good, maximum VAS score was 3. Patient was discharged at post-operative day 4.Discussion: Y-V plasty technique significantly reduces surgery time and has lower risk of devascularization of the UPJ. The success of the Y-V plasty depends on proper placement of the incision ensuring a broad-based flap of pelvis. Following incision the apex of the flap is advanced and secured with an interrupted suture ensuring no tension. The remaining gaps are then closed in an interrupted fashion. Conclusion: Laparoscopic Pyelolithotomy for large stone with Y-V Pyeloplasty was safe and effective alternative treatment of large pyelum calculi and UPJO.