[ROBOT-ASSISTED PYELOLITHOTOMY IN PELVIC KIDNEY].

Abstract

Introduction: Pelvic kidney is a congenital anomaly whereby the kidney fails to ascend to its normal anatomical location during early embryonic development. This, in turn, makes traditional surgical approaches for renal calculi challenging.

Aims: To summarize our experience with robotic-assisted pyelolithotomy (RPPK) for pelvic kidney stones.

Methods: A retrospective review of patients who underwent RPPK between 2014 and 2023 was conducted. Demographic data, stone characteristics (size and density), operative details, and postoperative outcomes were collected and analyzed.

Results: Four patients underwent RPPK between 2014 and 2023, three of whom were male. The mean age was 51.2 years (range: 45-54), BMI was 26.6 (22.3-32.2). All patients had a right-sided pelvic kidney. Two patients had previously undergone a failed attempt for ureteroscopy and laser lithotripsy. Stone diameter was 27.7 mm (17-35 mm) and estimated density was 1207.5 HU (905-1500 HU). Mean operative time was 265 minutes (200-323 minutes), while time from incision to closure was 142.2 minutes (95-225 minutes). No ureteral stent or surgical drain were left at the conclusion of the procedures. Upper urinary tract correction was not involved in any of the cases. Blood loss was negligible. The length of hospital stay was 2.2 days. No immediate complications were recorded within one week and one-month post-surgery. Mean follow-up length was 7.5 months (3-13 months).

Conclusions: RPPK is safe and effective in the management of pelvic kidney stones. The challenging renal anatomy, as well as stone size and density are not obstacles when it comes to the robotic approach in comparison to other fragmentation methods.