Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath
Objective: The treatment of large intra renal stones with concomitant ureteropelvic junction obstruction (UPJO) can be managed with concurrent procedures. Endoscopic assisted robotic pyelolithotomy and pyeloplasty has been demonstrated to be safe and effective yet the use of a ureteric access sheath...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2023-10-01
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| Series: | Urology Video Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590089723000488 |
| _version_ | 1797401727595446272 |
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| author | Alexander Combes Henry Wang Sean Heywood Sachinka Ranasinghe Jeremy Saad Raymond Ko Nicholas Mehan |
| author_facet | Alexander Combes Henry Wang Sean Heywood Sachinka Ranasinghe Jeremy Saad Raymond Ko Nicholas Mehan |
| author_sort | Alexander Combes |
| collection | DOAJ |
| description | Objective: The treatment of large intra renal stones with concomitant ureteropelvic junction obstruction (UPJO) can be managed with concurrent procedures. Endoscopic assisted robotic pyelolithotomy and pyeloplasty has been demonstrated to be safe and effective yet the use of a ureteric access sheath in such cases is not well documented. This article emphasises the use and advantages of a ureteric access sheath (UAS) to improve the control, decrease infection rates and minimise intrarenal pressures during endoscopic management in robotic pyelolithotomy and pyeloplasty. Patients and Surgical Procedure: A 46-year-old female with a left ureteropelvic junction obstruction (UPJO) underwent an endoscopic assisted robotic pyelolithotomy and pyeloplasty for management of her UPJO and removal of stones. The renal pelvis was identified, incised, and a ureteric access sheath (UAS) was inserted through a robotic port into the renal pelvis and controlled using a robotic arm. Flexible pyeloscopy and subsequent basket removal of the stones was performed minimising any potential spillage of irrigation fluid into the abdominal cavity. The pyelotomy was closed using an Anderson-Hynes dismembered pyeloplasty. Results: The operative time was 150 min and blood loss <50 ml. The patient was discharged on post-operative day 2 without any complications and a stable serum creatinine. Conclusion: Endoscopic assisted robotic pyelolithotomy and pyeloplasty with a UAS is a safe and effective procedure for managing a concurrent UPJO and intra renal stones. This technique gives the surgeon maximal control of UAS positioning and location and may also decrease intrarenal pressures and reduce the risk of infection. |
| first_indexed | 2024-03-09T02:14:17Z |
| format | Article |
| id | doaj.art-fc3b21202f7c45269233bccabcf1195b |
| institution | Directory Open Access Journal |
| issn | 2590-0897 |
| language | English |
| last_indexed | 2024-03-09T02:14:17Z |
| publishDate | 2023-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Urology Video Journal |
| spelling | doaj.art-fc3b21202f7c45269233bccabcf1195b2023-12-07T05:30:07ZengElsevierUrology Video Journal2590-08972023-10-0120100254Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheathAlexander Combes0Henry Wang1Sean Heywood2Sachinka Ranasinghe3Jeremy Saad4Raymond Ko5Nicholas Mehan6Corresponding author at: Department of Urology, Nepean Hospital, Debry Street, Kingswood, 2747, NSW, Australia.; Nepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaNepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaNepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaNepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaNepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaNepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaNepean Hospital, Debry Street, Kingswood, 2747, NSW, AustraliaObjective: The treatment of large intra renal stones with concomitant ureteropelvic junction obstruction (UPJO) can be managed with concurrent procedures. Endoscopic assisted robotic pyelolithotomy and pyeloplasty has been demonstrated to be safe and effective yet the use of a ureteric access sheath in such cases is not well documented. This article emphasises the use and advantages of a ureteric access sheath (UAS) to improve the control, decrease infection rates and minimise intrarenal pressures during endoscopic management in robotic pyelolithotomy and pyeloplasty. Patients and Surgical Procedure: A 46-year-old female with a left ureteropelvic junction obstruction (UPJO) underwent an endoscopic assisted robotic pyelolithotomy and pyeloplasty for management of her UPJO and removal of stones. The renal pelvis was identified, incised, and a ureteric access sheath (UAS) was inserted through a robotic port into the renal pelvis and controlled using a robotic arm. Flexible pyeloscopy and subsequent basket removal of the stones was performed minimising any potential spillage of irrigation fluid into the abdominal cavity. The pyelotomy was closed using an Anderson-Hynes dismembered pyeloplasty. Results: The operative time was 150 min and blood loss <50 ml. The patient was discharged on post-operative day 2 without any complications and a stable serum creatinine. Conclusion: Endoscopic assisted robotic pyelolithotomy and pyeloplasty with a UAS is a safe and effective procedure for managing a concurrent UPJO and intra renal stones. This technique gives the surgeon maximal control of UAS positioning and location and may also decrease intrarenal pressures and reduce the risk of infection.http://www.sciencedirect.com/science/article/pii/S2590089723000488PyeloscopyRobotic pyelolithotomyRobotic pyeloplastyUreteric Access Sheath |
| spellingShingle | Alexander Combes Henry Wang Sean Heywood Sachinka Ranasinghe Jeremy Saad Raymond Ko Nicholas Mehan Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath Urology Video Journal Pyeloscopy Robotic pyelolithotomy Robotic pyeloplasty Ureteric Access Sheath |
| title | Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath |
| title_full | Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath |
| title_fullStr | Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath |
| title_full_unstemmed | Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath |
| title_short | Endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath |
| title_sort | endoscopic assisted robotic pyelolithotomy and pyeloplasty for ureteropelvic junction obstruction and retrieval multiple large intrarenal calculi with ureteric access sheath |
| topic | Pyeloscopy Robotic pyelolithotomy Robotic pyeloplasty Ureteric Access Sheath |
| url | http://www.sciencedirect.com/science/article/pii/S2590089723000488 |
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