ORIGINAL ARTICLE   Free access

Minerva Urologica e Nefrologica 2019 October;71(5):537-43

DOI: 10.23736/S0393-2249.19.03432-5

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Robotic pyelolithotomy for the treatment of large renal stones: a single-center experience

Michele ZAZZARA ¹ ✉, Giuseppe CARDO ¹, Giovanni PAGLIARULO ¹, Arjan NAZARAJ ¹, Francesco P. MASELLI ¹, Cosimo DE NUNZIO ², Marcello SCARCIA ¹, Michele ROMANO ¹, Filippo PORTOGHESE ¹, Giuseppe M. LUDOVICO ¹

¹ Department of Urology, “F. Miulli” General Hospital, Acquaviva delle Fonti, Bari, Italy; ² Department of Urology, Sant’Andrea Hospital, Sapienza University, Rome, Italy

BACKGROUND: Few studies have reported robotic pyelolithotomy (RPL) series; furthermore, the most of all have reported small and single-center series. Herein we report our experience from 70 cases of complex kidney stones treated with RPL at our surgical center; this study reports the largest series of RPL in a minimal invasive experienced center.
METHODS: Between February 2016 and March 2018, 70 patients with complex renal stones (Guy’s Stone Score: 4) underwent RPL and included in a prospectively maintained institutional database. Baseline characteristics, clinical data, perioperative data, postoperative data and stone free status were assessed by descriptive statistics.
RESULTS: Of 70 patients, 72.85% presented renal pelvis stones. The mean maximum stone diameter was 33.1±14.5 mm (median 30 mm; interquartile range 22-40 mm). Mean total operative duration was 122.5±34.4 min (median 120 min; interquartile range 105-135 min). In two patients (2.8%), a grade III complications were noted; no major complications (grade IV-V) were noted. The complete SFR, after a single robotic procedure, was 92.8%.
CONCLUSIONS: Our findings suggest that RPL is a safe, reproducible and minimally invasive approach as treatment of large renal stones when endoscopic treatment failed or was not available. RPL permits to achieve an excellent stone free status, in a single definitive procedure

KEY WORDS: Kidney calculi; Robotic surgical procedures; Urolithiasis