[Initial experience with laparoscopic anatrophic nephrolithotomy]

Percutaneous nephrolithotomy is a recognized standard for minimally invasive treatment of large kidney stones. Percutaneous interventions for complete staghorn stones are associated with a higher risk of complications that precludes abandoning the traditional open operations, one of which is an anatrophic nephrolithotomy. This paper presents the first personal experience in laparoscopic transmesenteric anatrophic nephrolithotomy. The intervention was conducted in 3 patients (2 males and 1 female) aged 43 to 58 years, having a primary symptomatic complete left kidney staghorn stones sized from 7.2 to 9.1 cm along the longitudinal axis. Operation time ranged from 130 to 170 minutes, kidney warm ischemia time - from 21 to 24 minutes, blood loss - from 180 to 250 ml. The staghorn stone was completely extracted in 2 patients. In one patient, a 0.8 cm residual stone was left in the completely excluded calix, since it caused none clinical symptoms and did not impair urinary flow. At this stage, the number of laparoscopic procedures for complete staghorn nephrolithiasis is too small to carry out an adequate statistical analysis and draw any definite conclusions. Nevertheless, the first experience demonstrated not only plausibility but also the effectiveness of such operations.