Combined Robotic Pyelolithotomy and Laser Lithotripsy for Staghorn Calculi

Abstract

Introduction: Robotic-assisted pyelolithotomy (RAPL) has recently immerged as an alternative approach for the management of complex kidney stones. RAPL combines the benefits of minimally invasive surgery with the high stone clearance rates achieved by open lithotomy. Case Description:We describe the successful combination of RAPL and Holmium laser lithotripsy for the management of a staghorn calculus in a 57-year-old man who had previously undergone a failed percutaneous nephrolithotomy. Discussion and Conclusion:The 500-m Holmium laser fiber was navigated by the console surgeon, who also controlled the laser foot pedal, thus maximizing surgeon control of the procedure. The combination of robotically assisted laparoscopic surgery and Holmium laser lithotripsy is a feasible and safe management option for achieving clearance of complex renal stones. To the best of our knowledge, this appears to be the first reported case, confirming the safety and efficacy of this combined technique.

The Jews of Zante between theSerenissimaand the Sublime Porte: the local community and the Jewish consuls (sixteenth to seventeenth centuries)

“…From the early sixteenth century, every ship of a deadweight of at least 200 botte (approximately 126 tons) sailing between Venice and various Mediterranean ports had to anchor at Corfu or Zante for customs control, and these islands also served as emporia for goods entering and leaving the Adriatic Sea. 32 Zante's vicinity to the Ottoman territories of the Peloponnese and the western shores of central Greece, made it an ideal transit station for trade with these regions. The Venetian Senate enacted in 1520 a law exempting from customs goods that were temporarily disembarked in Zante and Corfu while in transit.…”