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Bloodless Laparoscopic Partial Splenectomy Assisted by Bipolar Radiofrequency Excision Hemostatic Device
Published on: November 4, 2022
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Nephrolithiasis Greater Than 2 cm and Splenomegaly
Maximiliano Lopez Silva1, Horacio Sanguinetti1, Jorge Aguilar1
1Department of Urology, Hospital de Clínicas José de San Martín , Buenos Aires, Argentina .
Journal of Endourology Case Reports
|September 1, 2016
Summary
A large kidney stone was successfully removed using retrograde intrarenal surgery. This minimally invasive approach avoided potential splenic injury in a patient with significant splenomegaly.
Area of Science:
- Nephrology
- Urology
- Surgical Innovation
Background:
- Management of large renal pelvic stones presents challenges.
- Massive splenomegaly can complicate surgical approaches to the left kidney.
- Minimally invasive techniques are preferred to reduce patient morbidity.
Observation:
- A 67-year-old male patient presented with a 15 mm left renal pelvis stone.
- Preoperative computed tomography (CT) revealed massive splenomegaly.
- The presence of splenomegaly posed a risk of splenic injury with standard surgical access.
Findings:
- Retrograde intrarenal surgery (RIRS) was selected as the surgical approach.
- RIRS allowed for direct access to the renal pelvis, bypassing the spleen.
- The procedure successfully achieved complete stone removal, with no residual fragments.
Implications:
- Retrograde intrarenal surgery is a viable and safe option for treating complex renal stones in patients with splenomegaly.
- This approach minimizes the risk of iatrogenic splenic injury.
- RIRS offers a minimally invasive solution for challenging nephrolithiasis cases.
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