Page 4 - World Journal of Laparoscopic Surgery

Bhanu P Sharma et al
AIMS AND OBJECTIVES Patients with multiple calculi, congenital or acquired
anatomical abnormalities (which preclude RLP), associ-
The aim of this study was to study the efficacy, safety, and
outcome of RLP. The study compared the advantages and ated bleeding diathesis, pregnancy, intractable urinary
complications of retroperitoneal pyelolithotomy (RPL) tract infection, intrarenal pelvis, and recurrent/residual
done laparoscopically with classical pyelolithotomy or OP. stones following open surgery were excluded from
the study.
Preoperatively, age, weight, height, detailed history,
MATERIALS AND METHODS
dietary habits, general physical examination, and previous
The present prospective clinical study was carried out in history of surgery were noted and recorded on patient’s
the Department of Surgery, Maharishi Markandeshwar proforma. Routine baseline investigations like hemoglo-
Institute of Medical Sciences and Research, Mullana, bin, total leukocyte count, differential leukocyte count
Haryana, India, from January 2012 to December 2015. with platelet count, blood sugar, serum electrolytes, chest
The study was approved by the ethical committee X-ray, electrocardiogram, urine routine, microscopy and
of Maharishi Markandeshwar Institute of Medical urine culture and sensitivity, blood urea, and serum cre-
Sciences and Research, Mullana. A total of 280 patients atinine were done in patients. Radiological investigations
of either sex and in the age group of 12 to 80 years were done mandatorily were X-ray kidney, ureter, bladder
taken for the study. The results were compared in both (KUB), ultrasonography KUB, and intravenous pyelogra-
techniques. phy (IVP) (Fig. 1). Additionally, plain computed tomogra-
phy scan and diethylene triamine pentaacetic acid scan
were done when required. All patients were given routine
Patient Selection
preoperative and postoperative antibiotics in injectable
The study was divided into two groups. Consent was form (ceftriaxone 1 gm, amikacin 500 mg, and metrogyl
taken from patients on whether they wanted to opt for 100 mL). The patient was placed in a lateral decubitus
open procedure or laparoscopic procedure. Group I position, and the kidney bridge was elevated to flatten out
consisted of 160 patients who underwent RLP. Group II the lumbar region.
consisted of 120 patients who underwent OP. All patients The RLP was performed using the same technique
were between age group of 12 and 80 years and had as in several standard laparoscopic renal procedures. In
unilateral and bilateral solitary pelvic stones (1–3 cm). general, three to four port placements were used.

Fig. 1: Intravenous pyelography with a stone in pelvis of left kidney
2