title: Simultaneous Bilateral Endoscopic Manipulation for Bilateral Renal Stones.
abstract: OBJECTIVE
  To report the first performance of simultaneous bilateral percutaneous nephrolithotomy and flexible ureteroscopy carried out in tandem by 2 different surgeons in a patient with bilateral medium-sized renal calculi, describing step-by-step details of the surgical technique.
  
  
  METHODS
  A 46-year-old man, affected with hyperparathyroidism, was diagnosed with asymptomatic bilateral medium-sized renal stones. An abdominal noncontrast computed tomography scan revealed a left single kidney stone with a maximum diameter of 16 mm and 2 right renal stones located in the pelvis and in the lower calyx, of 21 and 19 mm in maximum diameter, respectively. A bilateral simultaneous percutaneous nephrolithotomy on the right side and flexible ureteroscopy on the left side were therefore carried out.
  
  
  RESULTS
  The total operative time was 80 minutes. No intra- or postoperative complications were experienced. On postoperative day 1, the creatinine serum level was stable (0.7 mg/dL); he was discharged home 48 hours later. Ureteral stents were removed 7 days after the procedure. At 2 weeks follow-up, an abdominal noncontrast computed tomography scan showed a stone-free status and no changes in renal function were detected.
  
  
  CONCLUSIONS
  A simultaneous bilateral endoscopic manipulation is feasible and safe and it can be offered in the presence of medium-sized bilateral renal stones in high-volume centers by experienced surgeons.
authors.affiliation: Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy. Electronic address: drguidogiusti@gmail.com.
authors.forename: Guido
authors.initials: G
authors.lastname: Giusti
authors.affiliation: Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Proietti
authors.affiliation: Department of Anaesthesia and Intensive Care, IRCCS, Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Pasin
authors.affiliation: Department of Anaesthesia and Intensive Care, IRCCS, Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan, Italy.
authors.forename: Giuseppina M
authors.initials: GM
authors.lastname: Casiraghi
authors.affiliation: Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy.
authors.forename: Giulio M
authors.initials: GM
authors.lastname: Gadda
authors.affiliation: Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Rosso
authors.affiliation: Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy.
authors.forename: Ella
authors.initials: E
authors.lastname: Kinzikeeva
authors.affiliation: Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France.
authors.forename: Steeve
authors.initials: S
authors.lastname: Doizi
authors.affiliation: Ville Turro Division, Department of Urology, IRCCS, Ospedale San Raffaele, Milan, Italy.
authors.forename: Franco
authors.initials: F
authors.lastname: Gaboardi
authors.affiliation: Department of Urology, Tenon Hospital, Pierre and Marie Curie University, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Traxer
mesh_terms: D006801:Humans; D007669:Kidney Calculi / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D018666:Ureteroscopy