Abstract
Robotic surgery today has made a successful transition into mainstream clinical urological practice, providing minimally invasive surgical treatment options for complex extirpative and reconstructive procedures. It has particularly dominated urologic pelvic surgery including radical prostatectomy, radical cystectomy, and many gynecologic procedures (Menon M, Hemal AK, J Endourol 18(7):611–619, 2004; Hemal AK, Abol-Enein H, Shrivastava A, Shoma AM, Ghoneim MA, Menon M, Urol Clin North Am 31(4):719–729, 2004; Hemal AK, Kolla SB, Wadhwa P, J Urol 180(3):981–985, 2008]. It has successfully been employed in kidney surgery as well, especially donor nephrectomy, partial nephrectomy, and pyeloplasty for ureteropelvic junction obstruction (UPJO) (Phillips CK, Taneja SS, Stifelman MD, J Endourol 19:441–445, 2005; Gettman MT, Neururer R, Bartsch G, Peschel R, Urology 60:509–513, 2002). While urolithiasis is largely treated with shock wave lithotripsy (SWL) and endourological surgery (ureteroscopy [URS] and percutaneous nephrolithotomy [PCNL]), the role of laparoscopy has been explored as an alternative tool in managing urinary stone disease.Laparoscopic ureterolithotomy proved to be a viable alternative to open surgery, helping avoid incision related morbidity in candidates with impacted, large ureteral calculi which had failed an attempt at endourological management (Hemal AK, Goel A, Kumar M, Gupta NP, J Endourol 15(7):701–705, 2001). Laparoscopic stone surgery soon gained acceptance as a complementary minimally invasive technique, specifically to be used in the occasional case considered for open surgery. Stones in anteriorly placed calyceal diverticulum, pelvic stones in ectopic kidneys, assisting percutaneous access in ectopic kidneys formed some of the other indications for laparoscopic stone interventions (Ramakumar S, Segura JW, J Endourol 14(10):829–832, 2000). The use of laparoscopic pyelolithotomy was avidly contested with some authors extolling its virtues as an alternative to PCNL in medium-sized renal calculi unsuitable for SWL therapy and unfavorable calyceal anatomy (Gaur DD, Trivedi S, Prabhudesai MR, Gopichand M, J Laparoendosc Adv Surg Tech A 12(4):299–303, 2002; Yagisawa T, Ito F, Kobayashi C, Onitsuka S, Kondo T, Goto Y, Toma H, J Endourol 15(5):525–528, 2001); while others, though demonstrating its feasibility, were unable to show its superiority over PCNL vis-à-vis operative time and skill required, cosmesis and relative invasiveness (Goel A, Hemal AK, Int Urol Nephrol 35(1):73–76, 2003).The enhanced reconstructive capabilities of the robotic platform added another dimension to laparoscopic management of stone disease. We first explored the use of robot-assisted renal pelvic calculi retrieval during a concomitant pyeloplasty in February 2003 in Egypt. The experience prompted the genesis of usage of robotic-assisted laparoscopic pyelolithotomy, which resulted in the first large series of robotic extended pyelolithotomy (REP) wherein we focused on stone extraction of large renal calculi (partial staghorn calculi), even a complete staghorn calculus (Badani KK, Hemal AK, Fumo M, Kaul S, Shrivastava A, Rajendram AK, Yusoff NA, Sundram M, Woo S, Peabody JO, Mohamed SR, Menon M, World J Urol 24:198–201, 2006). We were successfully able to deal with such large renal pelvic bulky partial staghorn calculi even in cases with intra-renal pelvis, duplicating the technique of extended pyelolithotomy by developing the intrasinus space of Gil-Vernet (Meria P, Milcent S, Desgrandchamps F, Mongiat-Artus P, Duclos JM, Teillac P, Urol Int 75(4):322–326, 2005). The versatility provided by the robot has allowed application of robot-assisted procedures in a variety of indications in managing urinary stone disease at different locations (Table 12.1). Herein we describe our technique of robotic pyelolithotomy and ureterolithotomy.
This chapter contains a video segment which can be found at the URL: http://www.springerimages.com/Su
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Badani KK, Hemal AK, Fumo M, Kaul S, Shrivastava A, Rajendram AK, Yusoff NA, Sundram M, Woo S, Peabody JO, Mohamed SR, Menon M (2006) Robotic extended pyelolithotomy for treatment of renal calculi: A feasibility study. World J Urol 24:198–201
Lee RS, Passerotti CC, Cendron M, Estrada CR, Borer JG, Peters CA (2007) Early results of robot assisted laparoscopic lithotomy in adolescents. J Urol 177(6):2306–2309, discussion 2309–10
Nayyar R, Wadhwa P, Hemal AK (2007) Pure robotic extended pyelolithotomy: cosmetic replica of open surgery. J Robotic Surg 1:207–211
Hemal AK, Eun D, Tewari A, Menon M (2004) Nuances in the optimum placement of ports in pelvic and upper urinary tract surgery using the da Vinci robot. Urol Clin North Am 31(4):683–692
Meria P, Milcent S, Desgrandchamps F, Mongiat-Artus P, Duclos JM, Teillac P (2005) Management of pelvic stones larger than 20 mm: laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy? Urol Int 75(4):322–326
Casale P, Grady RW, Joyner BD, Zeltser IS, Kuo RL, Mitchell ME (2004) Transperitoneal laparoscopic pyelolithotomy after failed percutaneous access in the pediatric patient. J Urol 172(2):680–683, discussion 683
Gil-Vernet J (1965) New concepts in removing renal calculi. Urol Intl 20:255–288
Fitzpatrick JM, Sleight MW, Braack A, Marberger M, Wickham JEA (1980) Intrarenal access: effects on renal function and morphology. Br J Urol 52:409–414
Menon M, Hemal AK (2004) Vattikuti Institute prostatectomy: a technique of robotic radical prostatectomy: experience in more than 1000 cases. J Endourol 18(7):611–619
Hemal AK, Abol-Enein H, Shrivastava A, Shoma AM, Ghoneim MA, Menon M (2004) Robotic radical cystectomy and urinary diversion in the management of bladder cancer. Urol Clin North Am 31(4):719–729
Hemal AK, Kolla SB, Wadhwa P (2008) Robotic reconstruction for recurrent supratrigonal vesicovaginal fistulas. J Urol 180(3):981–985
Phillips CK, Taneja SS, Stifelman MD (2005) Robot-assisted laparoscopic partial nephrectomy: the NYU technique. J Endourol 19:441–445
Gettman MT, Neururer R, Bartsch G, Peschel R (2002) Anderson–Hynes dismembered pyeloplasty performed with the daVinci robotic system. Urology 60:509–513
Hemal AK, Goel A, Kumar M, Gupta NP (2001) Evaluation of laparoscopic retroperitoneal surgery in urinary stone disease. J Endourol 15(7):701–705
Ramakumar S, Segura JW (2000) Laparoscopic surgery for renal urolithiasis: pyelolithotomy, calyceal diverticulectomy, and treatment of stones in a pelvic kidney. J Endourol 14(10):829–832
Gaur DD, Trivedi S, Prabhudesai MR, Gopichand M (2002) Retroperitoneal laparoscopic pyelolithotomy for staghorn stones. J Laparoendosc Adv Surg Tech A 12(4):299–303
Yagisawa T, Ito F, Kobayashi C, Onitsuka S, Kondo T, Goto Y, Toma H (2001) Retroperitoneoscopic pyelolithotomy via a posterior approach for large impacted renal pelvic stone. J Endourol 15(5):525–528
Goel A, Hemal AK (2003) Evaluation of role of retroperitoneoscopic pyelolithotomy and its comparison with percutaneous nephrolithotripsy. Int Urol Nephrol 35(1):73–76
Hemal AK, Nayyar R, Gupta NP, Dorairajan LN (2010) Experience with robotic assisted laparoscopic surgery in upper tract urolithiasis. Can J Urol 17(4):5299–5305
Badalato GM, Hemal AK, Menon M, Badani KK (2009) Current role of robot-assisted pyelolithotomy for the management of large renal calculi: a contemporary analysis. J Endourol 23(10):1719–1722
Hemal AK (2011) Retroperitoneal Laparoscopy. Jour Endourology, (in press)
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Electronic Supplementary material
Video 13.1 Robotic extended pyelolithotomy (60.2 MB)
Rights and permissions
Copyright information
© 2011 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Hemal, A.K., Menon, M. (2011). Robot-Assisted Extended Pyelolithotomy and Ureterolithotomy. In: Su, LM. (eds) Atlas of Robotic Urologic Surgery. Current Clinical Urology. Humana Press. https://doi.org/10.1007/978-1-60761-026-7_13
Download citation
DOI: https://doi.org/10.1007/978-1-60761-026-7_13
Published:
Publisher Name: Humana Press
Print ISBN: 978-1-60761-025-0
Online ISBN: 978-1-60761-026-7
eBook Packages: MedicineMedicine (R0)