Laparoscopic Management of the Urinary Stones
Urology Journal,
Vol. 22 No. 02 (2025),
2 March 2025
,
Page 58-67
https://doi.org/10.22037/uj.v22i.8456
Abstract
Laparoscopic stone surgery was historically recommended only for cases involving concomitant ureteropelvic junction obstruction (UPJO), congenital abnormalities, or when other endourological procedures had failed as an alternative to open surgery. However, recent randomized clinical trials and meta-analyses involving patients with normal anatomy and large renal stones have shown that laparoscopic pyelolithotomy (LPL) has a higher success rate and lower complication rates compared to the gold standard, percutaneous nephrolithotomy (PCNL). Furthermore, stone recurrence appears to be lower following LPL compared to PCNL. Therefore, we suggest that current guidelines for stone treatment reconsider laparoscopy as an effective primary treatment for large kidney stones, rather than simply viewing it as an alternative option. Nonetheless, careful case selection and the surgeon's experience are critical for the success of this treatment.
- laparosopy
- pyelolithotomy
- Nephrolithotomy
- Ureterolithotomy
- Urinary stone
- laparoscopic ureterolithotomy
- Kidney stone
- Surgery
- Intervention
- Surgical treatment
- complication
- success rate
- laparoscopic pyelolithotomy
How to Cite
References
(1) Salvado, J. A., Guzmán, S., Trucco, C. A., Parra, C. A.: Laparoscopic pyelolithotomy: optimizing surgical technique. Journal of endourology, 23: 575, 2009
(2) Badani, K. K., Hemal, A. K., Fumo, M. et al.: Robotic extended pyelolithotomy for treatment of renal calculi: a feasibility study. World journal of urology, 24: 198, 2006
(3) Nambirajan, T., Jeschke, S., Albqami, N. et al.: Role of laparoscopy in management of renal stones: single-center experience and review of literature. Journal of endourology, 19: 353, 2005
(4) Pakmanesh, H., MohammadSalehi, S., Mirzaei, M. et al.: Medium-Term Stone Recurrence after zero-fragment transperitoneal Laparoscopic Pyelolithotomy Compared with Percutaneous Nephrolithotomy for Large Single Renal Pelvis Stones. Urol J, 21: 35, 2024
(5) Pakmanesh, H., Mirzaei, M., Mohammad_Salehi, S., Sharifian, R.: Different Aspect of Transperitoneal Laparoscopic Pyelolithotomy for Management of Pelvic Stones Larger than 20 mm: a Cuasi-Experimental Study in Male Patients. Men's Health Journal, 4: e13, 2020
(6) Desai, M., De Lisa, A., Turna, B. et al.: The Clinical Research Office of the Endourological Society Percutaneous Nephrolithotomy Global Study: Staghorn Versus Nonstaghorn Stones. Journal of Endourology, 25: 1263, 2011
(7) Mao, T., Wei, N., Yu, J., Lu, Y.: Efficacy and safety of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treatment of large renal stones: a meta-analysis. J Int Med Res, 49: 300060520983136, 2021
(8) Aminsharifi, A., Hosseini, M.-M., Khakbaz, A.: Laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for a solitary renal pelvis stone larger than 3 cm: a prospective cohort study. Urolithiasis, 41: 493, 2013
(9) Basiri, A., Tabibi, A., Nouralizadeh, A. et al.: Comparison of Safety and Efficacy of Laparoscopic Pyelolithotomy versus Percutaneous Nephrolithotomy in Patients with Renal Pelvic Stones: A Ran¬ domized Clinical Trial. Urology journal, 11: 1932, 2014
(10) Li, S., Liu, T.-Z., Wang, X.-H. et al.: Randomized controlled trial comparing retroperitoneal laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for the treatment of large renal pelvic calculi: a pilot study. Journal of endourology, 28: 946, 2014
(11) Jung, J. H., Cho, S. Y., Jeong, C. W. et al.: Laparoscopic stone surgery with the aid of flexible nephroscopy. Korean J Urol, 55: 475, 2014
(12) Khaitan, A., Gupta, N. P., Hemal, A. K. et al.: Post-ESWL, clinically insignificant residual stones: reality or myth? Urology, 59: 20, 2002
(13) Kingma, R. A., Doppen, C., Bus, M. T. J. et al.: The significance of clinically insignificant residual fragments after percutaneous nephrolithotomy: an analysis into the relevance of complete stone clearance. World Journal of Urology, 42: 78, 2024
(14) Xiao, Y., Li, Q., Huang, C. et al.: Perioperative and long-term results of retroperitoneal laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for staghorn calculi: a single-center randomized controlled trial. World J Urol, 37: 1441, 2019
(15) Ziaee, S. A., Kazemi, B., Moghaddam, S. M. et al.: A study of febrile versus afebrile patients after percutaneous nephrolithotomy regarding bacterial etiologic factors through blood and urine cultures and 16S rRNA detection in serum. J Endourol, 22: 2717, 2008
(16) Pakmanesh, H., Zahir, M., Farshi, A. et al.: Comparative analysis of retro vs. transperitoneal laparoscopic pyelolithotomy for large renal stones. Urolithiasis, 52: 137, 2024
(17) Pakmanesh, H., Salari, A.: Retroperitoneal vs transperitoneal laparoscopic pyelolithotomy; a single surgeon’s experience. World Journal of Urology, 42: 559, 2024
(18) Srivastava, A., Singh, K. J., Suri, A. et al.: Vascular complications after percutaneous nephrolithotomy: are there any predictive factors? Urology, 66: 38, 2005
(19) Rosette, J. d. l., Assimos, D., Desai, M. et al.: The clinical research office of the endourological society percutaneous nephrolithotomy global study: indications, complications, and outcomes in 5803 patients. Journal of endourology, 25: 11, 2011
(20) Mousavi-Bahar, S. H., Mehrabi, S., Moslemi, M. K.: Percutaneous nephrolithotomy complications in 671consecutive patients: a single-center experience. Urology journal, 8: 271, 2011
(21) Nouralizadeh, A., Ziaee, S. A. M., Hosseini Sharifi, S. H. et al.: Delayed postpercutaneous nephrolithotomy hemorrhage: Prevalence, predictive factors and management. Scandinavian Journal of Urology, 48: 110, 2014
(22) Li, Z., Wu, A., Liu, J. et al.: Risk factors for hemorrhage requiring embolization after percutaneous nephrolithotomy: a meta-analysis. Translational Andrology and Urology, 9: 210, 2020
(23) Chen, H., Chen, G., Chen, H. et al.: Comparison of the Safety and Efficacy between Transperitoneal and Retroperitoneal Approach of Laparoscopic Ureterolithotomy for the Treatment of Large (>10mm) and Proximal Ureteral Stones: A Systematic Review and Meta-analysis. Urol J, 18: 11, 2020
(24) Agrawal-Patel, S., Brar, H., Elia, M. et al.: Is it Safe to Continue Aspirin in Patients Undergoing Percutaneous Nephrolithotomy? Urology, 183: 32, 2024
(25) Gandhi, H. R., Thomas, A., Nair, B., Pooleri, G.: Laparoscopic pyelolithotomy: An emerging tool for complex staghorn nephrolithiasis in high-risk patients. Arab Journal of Urology, 13: 139, 2015
(26) Keller, E. X., De Coninck, V., Doizi, S., Traxer, O.: The role of ureteroscopy for treatment of staghorn calculi: A systematic review. Asian Journal of Urology, 7: 110, 2020
(27) Soltani, M. H., Kashi, A. H., Farshid, S., Mantegy, S. J., Valizadeh, R.: Transperitoneal laparoscopic pyelolithotomy versus percutaneous nephrolithotomy for treating the patients with staghorn kidney stones: A randomized clinical trial. Urology Journal, 19: 28, 2022
(28) Nouralizadeh, A., Simforoosh, N., Soltani, M. H. et al.: Laparoscopic transperitoneal pyelolithotomy for management of staghorn renal calculi. Journal of Laparoendoscopic & Advanced Surgical Techniques, 22: 61, 2012
(29) Pastore, A. L., Palleschi, G., Silvestri, L. et al.: Combined laparoscopic pyelolithotomy and endoscopic pyelolithotripsy for staghorn calculi: long-term follow-up results from a case series. Therapeutic Advances in Urology, 8: 3, 2016
(30) Labate, G., Modi, P., Timoney, A. et al.: The Percutaneous Nephrolithotomy Global Study: Classification of Complications. Journal of Endourology, 25: 1275, 2011
(31) Nouralizadeh, A., Pakmanesh, H., Basiri, A. et al.: Solo Sonographically Guided PCNL under Spinal Anesthesia: Defining Predictors of Success. Scientifica (Cairo), 2016: 5938514, 2016
(32) Pakmanesh, H., Kharazmi, F., Vejdani, S., Eslami, N.: Ultrasound-guided renal puncture followed by endoscopically guided tract dilatation vs standard fluoroscopy-guided percutaneous nephrolithotomy for non-opaque renal stones; a randomized clinical trial. Urolithiasis, 52: 75, 2024
(33) Sharifiaghdas, F., Tabibi, A., Nouralizadeh, A. et al.: Our Experience with Totally Ultrasonography-Guided Percutaneous Nephrolithotomy in Children. Journal of Endourology, 35: 749, 2015
(34) Shayani-Nasab, H., Amir-Zargar, M. A., Mousavi-Bahar, S. H. et al.: Complications of entry using direct trocar and/or veress needle compared with modified open approach entry in laparoscopy: six-year experience. Urology journal, 10: 861, 2013
(35) Bishoff, J. T., Allaf, M. E., Kirkels, W. et al.: Laparoscopic bowel injury: incidence and clinical presentation. The Journal of urology, 161: 887, 1999
(36) Al‐Hunayan, A., Abdulhalim, H., El‐Bakry, E., Hassabo, M., Kehinde, E. O.: Laparoscopic pyelolithotomy: is the retroperitoneal route a better approach? International Journal of urology, 16: 181, 2009
(37) Chen, H., Chen, G., Chen, H. et al.: Comparison of the Safety and Efficacy between Transperitoneal and Retroperitoneal Approach of Laparoscopic Ureterolithotomy for the Treatment of Large (>10mm) and Proximal Ureteral Stones: A Systematic Review and Meta-analysis. Urology Journal, 18: 11, 2020
(38) Al-Hunayan, A., Khalil, M., Hassabo, M., Hanafi, A., Abdul-Halim, H.: Management of solitary renal pelvic stone: laparoscopic retroperitoneal pyelolithotomy versus percutaneous nephrolithotomy. J Endourol, 25: 975, 2011
(39) Goel, A., Hemal, A.: Evaluation of role of retroperitoneoscopic pyelolithotomy and its comparison with percutaneous nephrolithotripsy. International urology and nephrology, 35: 73, 2003
(40) Meria, P., Milcent, S., Desgrandchamps, F. et al.: Management of pelvic stones larger than 20 mm: laparoscopic transperitoneal pyelolithotomy or percutaneous nephrolithotomy? Urologia internationalis, 75: 322, 2005
(41) Tepeler, A., Binbay, M., Sari, E. et al.: 563 THE COMPARISON OF LAPAROSCOPIC PYELOLITHOTOMY VERSUS PERCUTANEOUS NEPHROLITHOTOMY IN THE MANAGEMENT OF LARGE RENAL PELVIC STONES. European Urology Supplements, 4: 261, 2009
(42) Tanriverdi, O., Boylu, U., Kendirci, M. et al.: The learning curve in the training of percutaneous nephrolithotomy. Eur Urol, 52: 206, 2007
(43) Kashi, A. H., Simforoosh, N., Nouralizadeh, A. et al.: The experience of a tertiary referral center with laparoscopic pyelolithotomy for large renal stones during 18 years. Scientific Reports, 13: 23102, 2023
(44) Abat, D., Altunkol, A., Kuyucu, F. et al.: After a urological laparoscopic training programme, which laparoscopic method is safer and more feasible in the management of proximal ureteral stones: Transperitoneal or retroperitoneal? J Pak Med Assoc, 66: 971, 2016
(45) Zhu, H., Shen, C., Li, X. et al.: Laparoscopic pyeloplasty: a comparison between the transperitoneal and retroperitoneal approach during the learning curve. Urologia Internationalis, 90: 130, 2013
(46) Adam, A., Reddy, D.: "Vaginal Delivery": A Novel Extraction Route for Large Renal Calculi Encountered During Laparoscopic Pyeloplasty. Curr Urol, 12: 104, 2019
(47) Liou, L. S., Streem, S. B.: Long-term renal functional effects of shock wave lithotripsy, percutaneous nephrolithotomy and combination therapy: a comparative study of patients with solitary kidney. J Urol, 166: 36; discussion 36, 2001
(48) El-Tabey, N. A., El-Nahas, A. R., Eraky, I. et al.: Long-term functional outcome of percutaneous nephrolithotomy in solitary kidney. Urology, 83: 1011, 2014
(49) Matsuura, H., Hioki, T., Sakurai, M. et al.: [Influence of extracorporeal shock wave lithotripsy (ESWL) on renal function assessed by 99mTc-DMSA scintigraphy: comparative analysis between ESWL and percutaneous nephroureterolithotripsy (PNL)]. Hinyokika Kiyo, 40: 1061, 1994
(50) Aminsharifi, A., Alavi, M., Sadeghi, G., Shakeri, S., Afsar, F.: Renal parenchymal damage after percutaneous nephrolithotomy with one-stage tract dilation technique: a randomized clinical trial. J Endourol, 25: 927, 2011
(51) Yasui, T., Okada, A., Hamamoto, S. et al.: Efficacy of retroperitoneal laparoscopic ureterolithotomy for the treatment of large proximal ureteric stones and its impact on renal function. Springerplus, 2: 600, 2013
(52) Sharifiaghdas, F., Kashi, A. H., Eshratkhah, R.: Evaluating percutaneous nephrolithotomy-induced kidney damage by measuring urinary concentrations of β2-microglobulin. Urol J, 8: 277, 2011
(53) Kurien, A., Baishya, R., Mishra, S. et al.: The impact of percutaneous nephrolithotomy in patients with chronic kidney disease. J Endourol, 23: 1403, 2009
(54) Chow, A. K., Deane, L. A.: Robotic Pyelolithotomy for the Intact Removal of a Complete Staghorn Calculus: A Feasible Approach Even After a Previous Open Pyelolithotomy. Urology, 127: 133, 2019
(55) Radfar, M. H., Dadpour, M., Simforoosh, N. et al.: Laparoscopic pyelolithotomy in patients with previous ipsilateral renal stone surgery. Urologia, 88: 41, 2021
(56) Chen, R. N., Moore, R. G., Cadeddu, J. A. et al.: Laparoscopic renal surgery in patients at high risk for intra-abdominal or retroperitoneal scarring. J Endourol, 12: 143, 1998
(57) Cadeddu, J. A., Chan, D. Y., Hedican, S. P. et al.: Retroperitoneal access for transperitoneal laparoscopy in patients at high risk for intra-abdominal scarring. J Endourol, 13: 567, 1999
(58) Tomaszewski, J. J., Smaldone, M. C., Cung, B. et al.: Internal validation of the renal pelvic score: a novel marker of renal pelvic anatomy that predicts urine leak after partial nephrectomy. Urology, 84: 351, 2014
(59) Simforoosh, N., Radfar, M. H., Valipour, R., Dadpour, M., Kashi, A. H.: Laparoscopic Pyelolithotomy for the Management of Large Renal Stones with Intrarenal Pelvis Anatomy. Urol J, 18: 40, 2020
(60) Soltani, M. H., Shemshaki, H.: Stented Versus Stentless Laparoscopic Ureterolithotomy: A Systematic Review and Meta-Analysis. J Laparoendosc Adv Surg Tech A, 27: 1269, 2017
(61) Badani, K. K., Hemal, A. K., Fumo, M. et al.: Robotic extended pyelolithotomy for treatment of renal calculi: a feasibility study. World J Urol, 24: 198, 2006
(62) Pastore, A. L., Palleschi, G., Silvestri, L. et al.: Combined laparoscopic pyelolithotomy and endoscopic pyelolithotripsy for staghorn calculi: long-term follow-up results from a case series. Ther Adv Urol, 8: 3, 2016
(63) García-Seguí, A., Gascón-Mir, M.: [Nephroscopy with carbon dioxide in combination with laparoscopy in the treatment of urinary stones]. Actas Urol Esp, 36: 186, 2012
(64) Stein, R. J., Turna, B., Nguyen, M. M. et al.: Laparoscopic Pyeloplasty with Concomitant Pyelolithotomy: Technique and Outcomes. Journal of Endourology, 22: 1251, 2008
(65) Ramakumar, S., Segura, J. W.: Laparoscopic Surgery for Renal Urolithiasis: Pyelolithotomy, Caliceal Diverticulectomy, and Treatment of Stones in a Pelvic Kidney. Journal of Endourology, 14: 829, 2000
(66) Zeng, S. P., Sun, Y. F., Yu, H. Y., Yang, J., Deng, K. F.: Efficacy of flexible ureterorenoscopy with holmium laser in the management of calyceal diverticular calculi. Urolithiasis, 52: 50, 2024
(67) Zhang, J., Wu, Y., Jiang, S. et al.: Laparoscopic calyceal diverticulectomy: step-by-step surgical technique and clinical experience. Art of Surgery, 8, 2024
(68) Kaviani, A., Hosseini, J., Lotfi, B., Valipour, R., Sadeghian, I.: Disfiguring abdominal mass due to a huge extraordinary calyceal diverticulum. Urol J, 7: 284, 2010
(69) Radfar, M. H., Golshan, A., Hamedanchi, S., Pakmanesh, H.: Laparoscopic assisted ultrasound guided percutaneous nephrolithotomy (PCNL) in ectopic pelvic kidney. Journal of Research in Urology, 3: 28, 2019
(70) Pakmanesh, H., Basiri, A.: LAPAROSCOPIC REMOVAL OF NONFUNCTIONAL LOWER CALYX RESEMBLING SIMPLE CYST-CASE REPORT VIDEO PRESENTATION. Presented at the INTERNATIONAL JOURNAL OF UROLOGY, 2014
(71) Pakmanesh, H., Daneshpajooh, A., Mirzaei, M. et al.: Amplatz versus balloon for tract dilation in ultrasonographically guided percutaneous nephrolithotomy: a randomized clinical trial. BioMed Research International, 2019: 3428123, 2019
(72) Basiri, A., Arab, D., Pakmanesh, H., Abedinzadeh, M., Karami, H.: An overnight stay versus three days admission after uncomplicated percutaneous nephrolithotomy: a randomized clinical trial. Urology Journal, 17: 352, 2020
(73) Chong, J. T., Dunne, M., Magnan, B., Abbott, J., Davalos, J. G.: Ambulatory Percutaneous Nephrolithotomy in a Free-Standing Surgery Center: An Analysis of 500 Consecutive Cases. J Endourol, 35: 1738, 2021
(74) Aghamir, S. M., Hosseini, S. R., Gooran, S.: Totally tubeless percutaneous nephrolithotomy. J Endourol, 18: 647, 2004
(75) Vassileva, J., Zagorska, A., Karagiannis, A. et al.: Radiation Exposure of Surgical Team During Endourological Procedures: International Atomic Energy Agency–South-Eastern European Group for Urolithiasis Research Study. Journal of Endourology, 35: 574, 2020
(76) Elmarakbi, A. A., Elnoiry, A. K., Deiab, N., Lotfy, A. M.: Comparative study between radiation exposure in common urological procedures. Beni-Suef University Journal of Basic and Applied Sciences, 13: 2, 2024
(77) Nouralizadeh, A., Pakmanesh, H., Basiri, A. et al.: Solo sonographically guided PCNL under spinal anesthesia: defining predictors of success. Scientifica, 2016: 5938514, 2016
(78) Lee, R. S., Passerotti, C. C., Cendron, M. et al.: Early results of robot assisted laparoscopic lithotomy in adolescents. J Urol, 177: 2306, 2007
(79) Nouralizadeh, A., Sharifiaghdas, F., Pakmanesh, H. et al.: Fluoroscopy-free ultrasonography-guided percutaneous nephrolithotomy in pediatric patients: a single-center experience. World J Urol, 36: 667, 2018
(80) Deger, S., Tuellmann, M., Schoenberger, B. et al.: Laparoscopic anatrophic nephrolithotomy. Scand J Urol Nephrol, 38: 263, 2004
(81) Simforoosh, N., Aminsharifi, A., Tabibi, A. et al.: Laparoscopic anatrophic nephrolithotomy for managing large staghorn calculi. BJU Int, 101: 1293, 2008
(82) Giedelman, C., Arriaga, J., Carmona, O. et al.: Laparoscopic anatrophic nephrolithotomy: developments of the technique in the era of minimally invasive surgery. J Endourol, 26: 444, 2012
(83) El-Nahas, A. R., Elsawy, A. A., Abdelhalim, A., Elsaadany, M. M., Osman, Y.: Long-term effects of anatrophic nephrolithotomy on selective renal function. Urolithiasis, 47: 365, 2019
(84) Aminsharifi, A., Niroomand, R., Kroup, M., Hosseini, M. M.: Laparoscopic nephrolithotomy in a patient with crossed fused renal ectopia. Nature Reviews Urology, 6: 675, 2009
(85) Maheshwari, P. N., Bhandarkar, D. S., Andankar, M. G., Shah, R. S.: Laparoscopically guided transperitoneal percutaneous nephrolithotomy for calculi in pelvic ectopic kidneys. Surg Endosc, 18: 1151, 2004
(86) Ozturk, M. D., Sener, N. C., Goktug, H. N. et al.: The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones. Can Urol Assoc J, 7: E673, 2013
(87) Güler, Y., Erbin, A., Ozmerdiven, G., Yazici, O.: Comparison of Retrograde Intrarenal Surgery and Laparoscopic Surgery in the Treatment of Proximal Ureteral and Renal Pelvic Stones Greater than 15 mm. Folia Med (Plovdiv), 62: 490, 2020
(88) Radfar, M. H., Valipour, R., Narouie, B., Sotoudeh, M., Pakmanesh, H.: Role of the gonadal vessels on the stone lodgment in the proximal ureter: Direct observation during laparoscopic ureterolithotomy. Arch Ital Urol Androl, 90: 163, 2018
(89) EAU Guidelines. Edn. presented at the EAU Annual Congress Paris 2024. . 2024
(90) Assimos, D., Krambeck, A., Miller, N. L. et al.: Surgical Management of Stones: American Urological Association/Endourological Society Guideline, PART II. J Urol, 196: 1161, 2016
- Abstract Viewed: 117 times
- 8456/pdf Downloaded: 62 times