Laparoscopic Pyelolithotomy
The term pyelo means renal pelvis, and the term lithotomy means removal of stone. Since the advent of extracorporeal shockwave lithotripsy (ESWL) and percutaneous nephropyelolithotomy (PCN), pyelolithotomy is becoming an uncommon surgery in most developing countries. However, before these newer technologies, pyelolithotomy was the procedure of choice for stones within the renal pelvis, including stones that demonstrated minimal invasion into calyces and infundibulum. Pyelolithotomy differs from an anatrophicnephrolithotomy, as the anatrophicnephrolithotomy allows for greater access to calyces and allows for repair of infundibulum and calyces. Anatrophicnephrolithotomy is indicated for large multiple-branched staghorn calculi with infundibular stenosis.
A lap pyelolithotomy approach is rarely needed in patients requiring stone removal. However, it can be a safe and effective approach in the management of select patients with complex stone disease.