Laparoscopy-Assisted Percutaneous Nephrolithotripsy (PCNL) in Ectopic Pelvic Kidney

Abstract

An ectopic kidney is a rare developmental anomaly in which the kidney can be pelvic, iliac, abdominal, and thoracic, and affected patients are more prone to conditions such as reflux, pelvic ureteric junction (PUJ) obstruction, hydronephrosis, nephrolithiasis, and even renal failure than patients with normally structured kidneys. In this case, we present a 43-year-old male who is a known case of ectopic left pelvic kidney and presented with chronic lower abdominal pain. Upon imaging, it was revealed that he had a staghorn stone for which he underwent laparoscopy-assisted percutaneous nephrolithotripsy (PCNL).Postoperatively, the patient underwent a quick recovery and was discharged on postoperative day 3 without any perioperative complications. Hence given our experience with this case and the similar experiences of urologists over time, the use of laparoscopy-assisted PCNL appears to create a safe way of entering the abdomen and locating the ectopic kidney as well as provide visual guidance in puncture and dilatation all the while protecting the adjacent structures from harm. This demonstrates that laparoscopy-assisted PCNL is a feasible safe and minimally invasive procedure for patients with ectopic kidneys presenting with large stones.

Retrograde intrarenal surgery for stones associated with renal anomalies: caliceal diverticulum, horseshoe kidney, medullary sponge kidney, megacalycosis, pelvic kidney, uretero-pelvic junction obstruction

“…Pelvic ectopic kidney is a rare anomaly, which appears when the mature kidney fails to reach its location in the 'renal fossa'. Affected patients are more susceptible to conditions such as reflux, UPJO, hydronephrosis and nephrolithiasis and the left side is slightly more affected than the right [29]. Three recent reports concerning this pathology were published in 2021.…”