World Journal of Laparoscopic Surgery

Register      Login

VOLUME 10 , ISSUE 1 ( January-April, 2017 ) > List of Articles


Comparative Study of Surgical Approaches for Renal Pelvic Stones in a Northern Rural Medical College

Muzzafar Zaman, Bhanu P Sharma, Rikki Singal, Karamjot Sandhu, Kamal Sharma, Rahul Yadav, Preeti Grewal

Citation Information : Zaman M, Sharma BP, Singal R, Sandhu K, Sharma K, Yadav R, Grewal P. Comparative Study of Surgical Approaches for Renal Pelvic Stones in a Northern Rural Medical College. World J Lap Surg 2017; 10 (1):1-7.

DOI: 10.5005/jp-journals-10033-1292

Published Online: 01-06-2011

Copyright Statement:  Copyright © 2017; The Author(s).



Retroperitoneal pyelolithotomy (RPL) can be used as an alternative to open pyelolithotomy (OP) when other modalities of stone removal fail. This procedure even has potential to replace noninvasive techniques in selective subsets of patients.

Aims and objectives

The aim of this study was to study the efficacy, safety, and outcome of retroperitoneal laparoscopic pyelolithotomy. The study compared the advantages and complications of RPL and OP.

Materials and methods

This study was conducted in the Department of Surgery, Maharishi Markandeshwar Institute of Medical Science and Research, Maharishi Markandeshwar University, Ambala, from January 2012 to December 2015. A total of 280 patients of solitary renal pelvic stone were selected, out of whom 160 who underwent RPL were considered in group I and 120 patients who underwent OP were considered in group II. The patients included were of age group 12 to 80 years, with unilateral and bilateral solitary renal pelvis calculus and stone size of 10 mm to 3 cm. Patients with recurrent or residual stones after pyelolithotomy, intractable urinary tract infection, and having extrarenal pelvis and any anatomical renal abnormalities were excluded from the study.


In this study, mean age was 37.1 and 46.66 years in groups I and II respectively. Male to female ratio was 2.33:1. Mean operative time was 75.33 ± 16.90 and 65.83 ± 12.35 minutes respectively, in groups I and II respectively (p < 0.001). Pyelotomy closure time and Double-J (DJ) stent insertion time were 5.2 minutes (with standard deviation [SD] of 4.3) and 9.8 (with SD of 3.7) respectively, in group I as compared with 4.2 minutes (with SD of 2.7) and 6.1 (with SD of 2.9) in group II. Mean hospital stay was less in group I at 3.76 ± 0.85 days and, in group II, it was 5.36 ± 1.96 days (p < 0.001). Postoperative anesthesia requirement was 2.23 ± 0.62 days (339 ± 93 mg) and 5.36 ± 0.96 days (804 ± 144 mg) in groups I and II respectively (p < 0.001).


The RPL is a noninvasive and cost-effective method along with minimal scar mark. It has the advantages over OP of having fewer complications, less postoperative pain, better cosmesis, and less hospital stay.

How to cite this article

Sharma BP, Singal R, Zaman M, Sandhu K, Sharma K, Yadav R, Grewal P, Mishra RK. Comparative Study of Surgical Approaches for Renal Pelvic Stones in a Northern Rural Medical College. World J Lap Surg 2017;10(1):1-7.

PDF Share
  1. The role of open and laparoscopic stone surgery in the modern era of endourology. Nature Rev Urol 2015 Jul;12(7):392-400.
  2. Treatment of stones associated with complex or anomalous renal anatomy. Urol Clin North Am 2007 Aug;34(3):431-441.
  3. Pyelolithotomy improves while extracorporeal lithotripsy impairs kidney function. J Urol 1999 Jan;161(1):39-44.
  4. Laparoscopic pyeloplasty with concomitant pyelolithotomy: technique and outcomes. J Endourol 2008 Jun;22(6):1251-1255.
  5. Laparoscopic retroperitoneal pyelolithotomy open pyelolithotomy: a comparative study. Turkish J Urol 2012 Dec;38(4):195-200.
  6. Laparoscopic pyelolithotomy compared to percutaneous nephrolithotomy as surgical management for large renal pelvic calculi: a meta-analysis. J Urol 2013 Sep;190(3):888-893.
  7. Comparative study of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in the management of large renal pelvic stones. Can Urol Assoc J 2013 Mar-Apr;7(3-4):E171-E175.
  8. Retroperitoneal laparoscopic technique in treatment of complex renal stones: 75 cases. BMC Urol 2014 Feb;14:16.
  9. The efficacy, safety & outcomes of laparoscopic pyelolithotomy (retroperitoneoscopic pyelolithotomy) and its comparison with percutaneous nephrolithotomy. Int J Biomed Adv Res 2015 Apr;6(4):363-367.
  10. Retroperitoneoscopic operations in urology – initial experience. J Clin Med 2009;2(2):36-39.
  11. Retroperitoneal laparoscopic ureterolithotomy: a single centre 10 year experience. Int J Surg 2011;9(2):160-164.
  12. Laparoscopic ureterolithotomy: minimally invasive second line treatment. Int Urol Nephrol 2011 Sep;43(3):651-654.
  13. Ultrasonography-guided PNL in comparison with laparoscopic ureterolithotomy in the management of large proximal ureteral stone. Int Braz J Urol 2013 Jan-Feb;39(1):22-28.
  14. Laparoscopic transperitoneal ureterolithotomy: a single-center experience. J Laparoendosc Adv Surg Tech A 2013 Jun;23(6):495-499.
  15. Laparoscopic pyelolithotomy: is the retroperitoneal route a better approach? Int J Urol 2009 Feb;16(2);181-186.
  16. Evaluation of role of retroperitoneoscopic pyelolithotomy and its comparison with percutaneous nephrolithotripsy. Int Urol Nephrol 2003 Mar;35(1):73-76.
  17. Retroperitoneal laparoscopic pyelolithotomy versus extra corporeal shock-wave lithotripsy for management of renal stones. J Min Access Surg 2010 Oct;6(4):106-110.
  18. Laparascopic retroperitoneoscopic pyelolithotomy for management of Renal stones. Postgrad Med J 2010;10:50-53.
  19. Open renal approach: comparative analysis of sub-costal incision versus trans-costal incision with excision of 12th rib. Pak J Med Sci 2009 Jul;25(4):557-562.
  20. Comparison of safety and efficacy of laparoscopic pyelolithotomy versus percutaneous nephrolithotomy in patients with renal pelvic stones: a randomized clinical trial. Urol J 2014 Nov;11(6):1932-1937.
  21. A comparative study on percutaneous nephrolithotomy and retroperitoneoscopic pyelolithotomy in large renal pelvic stone. JEMDS 2014 Apr;3(17):4446-4459.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.