title: Complex cystine kidney stones treated with combined robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy.
abstract: BACKGROUND
  Cystinuria, a rare autosomal recessive disease characterized by a defect in cystine renal reabsorption, can often determine complex cystine renal calculi, leading to important complications such as urinary obstruction, urinary infections, and impaired kidney function. Complex kidney stones can have a difficult management and can be very arduous to treat.
  
  
  METHODS
  We present the case of a 20-year-old Jeowah's witness woman with complex cystine renal stones treated with combined robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy.
  
  
  CONCLUSIONS
  The combination of robot-assisted laparoscopic pyelolithotomy and intraoperative renoscopy can be useful to achieve an immediate high stone clearance rate also in complex renal stones. This combined technique could be indicated to minimize intraoperative bleeding. Moreover, it can also be used in pediatric cases or when there is no ureteral compliance. However, this strategy can be performed only in hospital referral centers by expert surgeons.
authors.affiliation: 1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua - Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Meggiato
authors.affiliation: 1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua - Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Cattaneo
authors.affiliation: 1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua - Italy.|2 Department of Medicine, Surgical Pathology and Cytopathology Unit, University of Padua, Padua - Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Zattoni
authors.affiliation: 1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua - Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Dal Moro
authors.affiliation: 1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua - Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Beltrami
authors.affiliation: 1 Department of Oncological and Surgical Sciences, Urology Clinic, University of Padua, Padua - Italy.
authors.forename: Filiberto
authors.initials: F
authors.lastname: Zattoni
mesh_terms: D003131:Combined Modality Therapy; D003553:Cystine / Q000032:analysis; D004724:Endoscopy; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D007669:Kidney Calculi / Q000737:chemistry / Q000601:surgery*; D010535:Laparoscopy; D000074643:Nephrotomy; D065287:Robotic Surgical Procedures; D055815:Young Adult
chemical_list: D003553:Cystine
keywords: Cystine; Kidney stones; Laparoscopic; Pyelolithotomy; Renoscopy; Robotic