Guido Giusti1, Silvia Proietti2, Laura Pasin3, Giuseppina M Casiraghi3, Giulio M Gadda2, Marco Rosso2, Ella Kinzikeeva2, Steeve Doizi4, Franco Gaboardi2, Olivier Traxer4. 1. Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy. Electronic address: drguidogiusti@gmail.com. 2. Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy. 3. Department of Anaesthesia and Intensive Care, IRCCS, Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy. 4. Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France.
Abstract
OBJECTIVE: To report the first performance of simultaneous bilateral percutaneous nephrolithotomy and flexible ureteroscopy carried out in tandem by 2 different surgeons in a patient with bilateral medium-sized renal calculi, describing step-by-step details of the surgical technique. MATERIALS AND METHODS: A 46-year-old man, affected with hyperparathyroidism, was diagnosed with asymptomatic bilateral medium-sized renal stones. An abdominal noncontrast computed tomography scan revealed a left single kidney stone with a maximum diameter of 16 mm and 2 right renal stones located in the pelvis and in the lower calyx, of 21 and 19 mm in maximum diameter, respectively. A bilateral simultaneous percutaneous nephrolithotomy on the right side and flexible ureteroscopy on the left side were therefore carried out. RESULTS: The total operative time was 80 minutes. No intra- or postoperative complications were experienced. On postoperative day 1, the creatinine serum level was stable (0.7 mg/dL); he was discharged home 48 hours later. Ureteral stents were removed 7 days after the procedure. At 2 weeks follow-up, an abdominal noncontrast computed tomography scan showed a stone-free status and no changes in renal function were detected. CONCLUSION: A simultaneous bilateral endoscopic manipulation is feasible and safe and it can be offered in the presence of medium-sized bilateral renal stones in high-volume centers by experienced surgeons.
OBJECTIVE: To report the first performance of simultaneous bilateral percutaneous nephrolithotomy and flexible ureteroscopy carried out in tandem by 2 different surgeons in a patient with bilateral medium-sized renal calculi, describing step-by-step details of the surgical technique. MATERIALS AND METHODS: A 46-year-old man, affected with hyperparathyroidism, was diagnosed with asymptomatic bilateral medium-sized renal stones. An abdominal noncontrast computed tomography scan revealed a left single kidney stone with a maximum diameter of 16 mm and 2 right renal stones located in the pelvis and in the lower calyx, of 21 and 19 mm in maximum diameter, respectively. A bilateral simultaneous percutaneous nephrolithotomy on the right side and flexible ureteroscopy on the left side were therefore carried out. RESULTS: The total operative time was 80 minutes. No intra- or postoperative complications were experienced. On postoperative day 1, the creatinine serum level was stable (0.7 mg/dL); he was discharged home 48 hours later. Ureteral stents were removed 7 days after the procedure. At 2 weeks follow-up, an abdominal noncontrast computed tomography scan showed a stone-free status and no changes in renal function were detected. CONCLUSION: A simultaneous bilateral endoscopic manipulation is feasible and safe and it can be offered in the presence of medium-sized bilateral renal stones in high-volume centers by experienced surgeons.
Authors: Oriol Angerri; Olga Mayordomo; Andres Koey Kanashiro; Felix Millan-Rodriguez; Francisco Maria Sanchez-Martin; Sung-Yo Cho; Eran Schreter; Mario Sofer; Saeed Bin-Hamri; Ahmed Alasker; Yiloren Tanidir; Tarik Emre Sener; Panagiotis Kalidonis; Joan Palou-Redorta; Esteban Emiliani Journal: Cent European J Urol Date: 2019-05-30