Mediathek

A challenging case – From percutaneous stone removal to robotic pyeloplasty with ureteropyelostomy

12.10.20207:43Englisch

Abstract

A challenging case – From percutaneous stone removal to robotic pyeloplasty with ureteropyelostomy

F. Brüning1, H. Heers1, A. Hegele2, R. Hofmann1, C. Keil1
1Universitätsklinikum Marburg, Klinik für Urologie und Kinderurologie, Marburg, Deutschland, 2Urologisches Zentrum Mittelhessen, Biedenkopf, Deutschland

Introduction and objective: We report about a 75 years old female patient presenting at our hospital with a right sided partial staghorn stone of the lower calyx and a 6mm stone of the middle calyx for endoscopic stone removal after recurrent episodes of flank pain.
Methods: Combined ureterorenoscopic and percutaneous access was intended for stone removal. During ureteroscopy a duplicated collecting system with a high ureter fissus and filiform stenosis of both ureters at the confluence was found. Ureterorenoscopy could not be completed due to the stenosis. A double-J-stent was placed in the lower moiety of the collecting system. After pre-stenting both stones could be removed by combined ureterorenoscopic and percutaneous access. After complete stone removal a robotic assisted modified pyeloplasty with a ureteropyelostomy of the upper ureter was performed. Postoperative course was uneventful, after removal of the Websinger and DJ stent radiologic and sonographic examination showed no extravasation or dilatation of the urinary tract.
Conclusions: Even in a complex case with unusual anatomy endoscopic and robotic assisted procedures can be done safely and with benefit for the patients.
 

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A challenging case – From percutaneous stone removal to robotic pyeloplasty with ureteropyelostomy
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