Synchronized bilateral percutaneous nephrolithotripsy in a horseshoe kidney

Area of Science:

• Urology
• Nephrology
• Surgical Innovation

Background:

• Horseshoe kidneys present unique challenges for stone management due to their anatomical configuration.
• Percutaneous nephrolithotripsy (PCNL) is a recognized treatment for large renal stones.
• Simultaneous bilateral PCNL has been previously reported with a single surgeon.

Purpose of the Study:

• To describe a novel technique for managing bilateral staghorn calculi in a horseshoe kidney.
• To evaluate the feasibility and safety of synchronized bilateral PCNL performed by two surgical teams.

Main Methods:

• A patient with bilateral staghorn calculi in a horseshoe kidney underwent synchronized bilateral PCNL.
• Two surgical teams operated concurrently on each renal unit under a single anesthetic.
• Standard PCNL techniques were employed by each team.

Main Results:

• The synchronized bilateral PCNL procedure was successfully completed.
• The technique allowed for efficient management of complex staghorn calculi in both kidneys.
• No major intraoperative or postoperative complications were reported.

Conclusions:

• Synchronized bilateral PCNL by two surgical teams is a safe and effective approach for treating complex staghorn calculi in horseshoe kidneys.
• This technique represents an advancement in managing challenging stone burdens in this patient population.
• Further studies may explore the broader application of this synchronized approach.