Laparoscopic retroperitoneal pyelolithotomy at UP Rural Institute of Medical Sciences and Research: our initial experience of 25 cases

Background: To establish the feasibility of the retroperitoneal laparoscopic approach for treatment of patients with renal calculi who are under consideration for an open pyelolithotomy. Methods: Laparoscopic retroperitoneal pyelolithotomy (LRP) was performed in twenty-five patients with renal calculi between 25 and 55 mm in largest diameter (solitary and staghorn). One of the patients also had multiple caliceal stones. These patients wanted an open procedure but had agreed to have their stone removal done laparoscopically in view of our experience. The classical retroperitoneal laparoscopic approach was used, and the trick to tackle some of the specific problems in such patients is also detailed. Results: The stones were removed successfully in all the twenty-five patients, and there were no complications, except prolonged drainage of urine in one of them postoperative because of non-placement of double J Stent intraoperatively. Conclusions: Although no definitive conclusion can be drawn from this small series, the paper shows the feasibility of the retroperitoneal laparoscopic approach in a select group of patients with renal calculi. It also provides the technical tips for the beginners in the laparoscopic exploration of the retroperitoneal space more effectively.