Rajinder Yadav
Fortis Superspeciality Hospital, India
Title: Advanced retroperitoneoscopic surgery in renal stones
Biography
Biography: Rajinder Yadav
Abstract
Introduction & Purpose: Staghorn and multiple renal stone diseases have been a challenging problem, and require multiple modalities for complete clearance. The purpose of this study is to discuss about the innovative and advanced retroperitoneoscopic surgery performed for this morbid condition.
Material & Method: Since 1992, 336 cases of urinary stones were operated by this technique out of which, 65 cases were of staghorn and multiple stone diseases. Apart from laparoscopic instruments, rigid and flexible nephroscope, dormia basket, grasping forceps and flushing cannula were used. Standard kidney position was used with 3 to 4 ports. 43 cases were male, 22 cases were female. The age of the patients ranged from 11 years to 65 years. Ureteric catheter or DJ stent was introduced before operation.
Results: All the operations were performed successfully except two conversations in initial period. Blood transfusion was given into two patients in the post-operative period (one unit in each patient). Post-operative urine leak stopped in 24 to 72 hrs. Duration of surgery ranged from two hours 45 minutes to four hours 35 minutes. Post-operative x-rays showed residual stones in kidney in three patients and in the retroperitoneum in four patients. Residual stones in kidney were treated by ESWL after six weeks. Hospital stay was 4-6 days. No postoperative urinary tract infection occurred from the surgery. Two patients had port infection. One patient had urinoma due to lockage of drain.
Conclusion: Retroperitoneoscopic surgery for staghorn and multiple stones is minimally invasive and less traumatic to kidney. It is comparable with open surgery and accepted by patients. Post-operative discomfort in more as compared By PCNL.