Role of Laparoscopic Retroperitoneal Pyelolithotomy in the Management of Large Renal Calculi: A Retrospective Study of 45 Cases in an Indian Rural Tertiary Care Centre

Objective: We evaluated the role of laparoscopic retroperitoneal pyelolithotomy in the management of large renal calculi.

Methods: A retrospective study including 45 cases (male, 27; female, 18) of solitary renal calculi of size more than 2.5cm were evaluated. There were 41 patients with single calculus, 4 patients with a staghorn calculus. Laparoscopic retroperitoneal pyelolithotomy was performed using balloon dissection with minor modifications.

Results: Stone clearance was achieved in all forty-five cases. The mean operative time was 90 min. Postoperative hospital stays averaged 5 days. Patients were ambulatory in 24 hours and returned to work in 7 days on average. The minor complications encountered were peritoneal rent, balloon rupture, and superficial wound infection. The postoperative analgesic requirement was average, the patients required 1 tablet of diclofenac sodium (50 mg of diclofenac) for an average duration of 2 days.

Conclusions: Laparoscopic retroperitoneal pyelolithotomy is a suitable minimally invasive method for the treatment of patients with staghorn and large renal calculi in centers without robotic facilities.