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Robot-assisted laparoendoscopic single-site surgery for the simultaneous management of multiple urinary tract calculi: a case report and experience sharing.
BMC Urology ( IF 2 ) Pub Date : 2019-12-30 , DOI: 10.1186/s12894-019-0572-3
Fan Zhang 1, 2 , Lisong Shan 2 , Jiahui Yin 2 , Luyang Liu 2 , Pengchao Wang 2 , Shengkun Sun 1, 2 , Xu Zhang 1 , Hongzhao Li 1 , Xin Ma 1 , Gang Guo 1 , Qiming Liu 2
Affiliation  

BACKGROUND Urolithiasis is a clinically common benign disease in urology. Surgical treatments that are widely used in urolithiasis are percutaneous nephrolithotomy, rigid/flexible ureteroscopy, laparoscopic surgery, and endoscopic combined intrarenal surgery. The da Vinci surgical system is rarely used in the treatment of urolithiasis. In the current study, we report a case of multiple urinary tract calculi treated by robot-assisted laparoendoscopic single-site (RA-LESS) surgery. CASE PRESENTATION A 49-year-old male patient was admitted to our hospital and diagnosed with multiple urinary tract calculi. He previously underwent right ureterolithotomy, laparoscopic cholecystectomy, and extracorporeal shockwave lithotripsy. Computed tomography (CT) scan and three-dimensional reconstruction CT image showed that multiple calculi were located in the right kidney, right upper ureter, and bladder. The preoperative glomerular filtration rate (GFR) were 17.81 ml/min (right kidney) and 53.11 ml/min (left kidney). We utilized the da Vinci system docking with a single-site port to perform pyelolithotomy, ureterolithotomy, and cystolithotomy, simultaneously. The operative time was 135 min and estimated blood loss was 30 ml. The postoperative hospital stay was 5 days. Three months after surgery, the serum creatinine and urea nitrogen levels dropped to a normal range, and no residual fragments were found in the CT scan. The postoperative GFR were 26.33 ml/min (right kidney) and 55.25 ml/min (left kidney). CONCLUSIONS RA-LESS surgery is a safe and effective surgical procedure in the treatment of multiple urinary tract calculi; however, further investigation is needed to validate its long-term therapeutic effect.

中文翻译:

机器人辅助腹腔镜单部位手术同时治疗多条尿路结石:一个病例报告和经验分享。

背景技术尿石症是泌尿科临床上常见的良性疾病。在尿路结石中广泛使用的手术治疗是经皮肾镜取石术,刚性/柔性输尿管镜检查,腹腔镜手术和内窥镜联合肾内手术。达芬奇手术系统很少用于治疗尿路结石。在本研究中,我们报告了通过机器人辅助腹腔镜单部位(RA-LESS)手术治疗的多尿路结石一例。病例介绍一名49岁的男性患者被我院收治,并被诊断出患有多条尿路结石。他以前接受过右输尿管结石切除术,腹腔镜胆囊切除术和体外冲击波碎石术。计算机断层扫描(CT)扫描和三维重建CT图像显示,右肾,右上输尿管和膀胱中有多个结石。术前肾小球滤过率(GFR)为17.81 ml / min(右肾)和53.11 ml / min(左肾)。我们利用达芬奇系统与单站点端口对接的方式,同时进行了开石术,输尿管结石术和膀胱切开术。手术时间为135分钟,估计失血量为30毫升。术后住院5天。手术三个月后,血清肌酐和尿素氮水平降至正常范围,在CT扫描中未发现残留碎片。术后GFR为26.33 ml / min(右肾)和55.25 ml / min(左肾)。结论RA-LESS手术是治疗多尿路结石的一种安全有效的手术方法。但是,需要进一步研究以验证其长期治疗效果。
更新日期:2020-04-22
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