V9-12 LAPROSCOPIC PYELOLITHOTOMY IN AN ECTOPIC PELVIC KIDNEY

Abstract

placed into the lower pole moiety and the patient was placed in a modified flank position with the left side up. All ports were placed in the midline with 2 assistant ports for retraction. The robot was docked perpendicular to the patient. After identifying the cross fused segment, ureterolysis of the lower pole ureter was performed. Laparoscopic ultrasound was used to identify the renal stones. A vertical pyelotomy in the fused lower pole renal pelvis was created and stones were removed. Ultrasound identified the remaining renal stone in the upper pole moiety of the fused segment. A second pyelotomy was created and the final stone was removed. The UPJ of the lower pole moiety was dismembered and the ureter was spatulated. An Anderson-Hynes pyeloplasty was then completed over our previously placed ureteral stent and the pyelotomies were closed with 3-0 V-loc suture. RESULTS: The patient tolerated the procedure well and was discharged home on post-operative day 3. Our operative time was 331 minutes with an estimated blood loss of 50 mL. His post-operative creatinine level was 0.85 mg/dl and at one-month follow up, his diuretic radionuclide scan demonstrated no evidence of urinary tract obstruction with a T1/2 of 12.9 minutes. CONCLUSIONS: Robotic pyelolithotomy with ureteropelvic junction reconstruction can be considered in patients with cross fused ectopia and nephrolithiasis who have failed traditional treatment modalities.