Abstract
BackgroundUrolithiasis is a clinically common benign disease in urology. Surgical treatments that are widely used in urolithiasis are percutaneous nephrolithotomy, rigid/flexible ureteroscopy, laparoscopic surgery, and endoscopic combined intrarenal surgery. The da Vinci surgical system is rarely used in the treatment of urolithiasis. In the current study, we report a case of multiple urinary tract calculi treated by robot-assisted laparoendoscopic single-site (RA-LESS) surgery.Case presentationA 49-year-old male patient was admitted to our hospital and diagnosed with multiple urinary tract calculi. He previously underwent right ureterolithotomy, laparoscopic cholecystectomy, and extracorporeal shockwave lithotripsy. Computed tomography (CT) scan and three-dimensional reconstruction CT image showed that multiple calculi were located in the right kidney, right upper ureter, and bladder. The preoperative glomerular filtration rate (GFR) were 17.81 ml/min (right kidney) and 53.11 ml/min (left kidney). We utilized the da Vinci system docking with a single-site port to perform pyelolithotomy, ureterolithotomy, and cystolithotomy, simultaneously. The operative time was 135 min and estimated blood loss was 30 ml. The postoperative hospital stay was 5 days. Three months after surgery, the serum creatinine and urea nitrogen levels dropped to a normal range, and no residual fragments were found in the CT scan. The postoperative GFR were 26.33 ml/min (right kidney) and 55.25 ml/min (left kidney).ConclusionsRA-LESS surgery is a safe and effective surgical procedure in the treatment of multiple urinary tract calculi; however, further investigation is needed to validate its long-term therapeutic effect.
Highlights
Urolithiasis is a clinically common benign disease in urology
We present a case of multiple urinary tract calculi treated by robotassisted laparoendoscopic single-site (RA-LESS) surgery at our center
No residual fragments were found in the Computed tomography (CT) scan (Fig. 5a to c)
Summary
Urolithiasis is a clinically common benign disease in urology. Surgical treatments that are widely used in urolithiasis are percutaneous nephrolithotomy, rigid/flexible ureteroscopy, laparoscopic surgery, and endoscopic combined intrarenal surgery. We report a case of multiple urinary tract calculi treated by robot-assisted laparoendoscopic singlesite (RA-LESS) surgery. Case presentation: A 49-year-old male patient was admitted to our hospital and diagnosed with multiple urinary tract calculi. He previously underwent right ureterolithotomy, laparoscopic cholecystectomy, and extracorporeal shockwave lithotripsy. The common surgical procedures for multiple calculi and/or complicated calculi are percutaneous nephrolithotomy (PCNL), rigid/flexible ureteroscopy (URS), laparoscopic surgery, Zhang et al BMC Urology (2019) 19:139 that improves surgical precision [9]. Robotassisted laparoscopic surgery is rarely used in the treatment of urolithiasis. We present a case of multiple urinary tract calculi treated by robotassisted laparoendoscopic single-site (RA-LESS) surgery at our center
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