title: Robotic extended pyelolithotomy for complete staghorn calculus.
abstract: Staghorn stones represent a therapeutic challenge to urologists. We present our experience with laparoscopic extended pyelolithotomy for treatment of staghorn and complex renal calculi in highly selected cases. This approach provides the principles of open surgery with the advantages of minimally invasive surgery. We describe our experience with robot-assisted extended pyelolithotomy for complex coralliform calculi. Since January 2007, robotic extended pyelolithotomy has been performed by transperitoneal approach in two patients with complete coralliform lithiasis (calculi average size 8 cm). One patient had history of percutaneous nephrolithotomy. Demographic and operative data were collected. All procedures were technically successful without need for open conversion. Mean estimated blood loss was 175 ml (range 50-300 ml), and mean operative time was 150 min (range 120-150 min). A perinephric drain was employed in one patient with duration of 5 days. Postoperative imaging confirmed complete stone clearance. Robotic extended pyelolithotomy is a feasible and reproducible procedure for removal of complete and partial staghorn calculi in selected patients with complex nephrolithiasis. This approach might limit the role of open surgery for these calculi, but further publications with more cases are necessary to further define its utility.
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela. renesotelo@mac.com.
authors.forename: Rene
authors.initials: R
authors.lastname: Sotelo
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Astigueta
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela.
authors.forename: Camilo
authors.initials: C
authors.lastname: Giedelman
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela.
authors.forename: Robert
authors.initials: R
authors.lastname: de Andrade
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela.
authors.forename: Oswaldo
authors.initials: O
authors.lastname: Carmona
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ramirez
authors.affiliation: Centro de Cirugía Robótica y de Invasión Mínima Unidad de Urología, Instituto Médico La Floresta, Calle Santa Ana Urbanización La Floresta, Annex B, 2nd Floor, Caracas, Venezuela.
authors.forename: Rafael
authors.initials: R
authors.lastname: Clavijo
keywords: Nephrolithiasis; Pyelolithotomy; Robotic; Staghorn calculus