Extending the utilization of the da Vinci robotic surgical system to pyelolithotomy

17^th International Conference on Nephrology & Urology

March 12-13, 2018 London, UK

Mohamad Waseem Salkini

West Virginia University, USA

Keynote: J Nephrol Ther

Abstract :

Percutaneous Nephrolithotripsy (PCNL) is considered the standard treatment for large kidney stone (>2 cm) and large stone burdon. However, and in certain patients, the technique can be challenging and fails. We utilized the da Vinci�® surgical robotic system to remove kideny stone in certain circumstansis. Robotic assisted laparoscopic pyelolithotomy (RALPL) was performed at our institute to treat large kidney stones (>2 cm) in morbidly obese patient (BMI >35), patients with skelital deformity that prevent percutaneous access to the kidney or positioning for the access, and after PCNL failure. We also performed RALPL whenever the robotic system was used for other purpose like pyeloplasty, partial nephrectomy, utereal reconstruction on the same kidney. RALPL allowed us to utilize other endoscopic intruments to achieve high rate of stone clearance. Seventeen patients underwent RALPL at our institute including 19 renal units. Average BMI in all patients was 38.5 kg/m2 (range 17.7-61.4 kg/m2) and all had prior abdominal surgeries The indication for RALPL was morbid obesity (n=8, mean BMI 56.4 kg/m2), need for concurrent renal surgery (n=3), severe contractures limiting positioning for retrograde endoscopic or percutaneous nephrolithotripsy (n=2), symptomatic calyceal diverticular stone with failed endoscopic approach (n=2) and patient preference over percutaneous nephrolithotripsy after failed PCNL (n=2). Patients had a mean of 2.3 stones and total stone volume of 16.5 cm3 (range 0.7-75 cm3) per kidney. Average blood loss was 57.8 mL and mean operative time was 180 minutes. Mean hospital stay was 3.5 days. Mean follow-up was 54 days and 91 % of patients were rendered stone free.

Biography :

Mohamad Waseem Salkini is an Associate Professor of Urology and Chief of Urologic Oncology. He is also a Director of Simulation and Robotic Surgery Program at West Virginia University. He earned his MD from Damascus University in 1998, and completed Urology Residency Program in 2003 at Damascus University. He was fellow with Heidleberg University and University of Cininnati for the years 2003-2004 and 2007-2009 respectively. He served as Research Fellow with University of Arizona from 2004-2007.
Email:msalkini@hsc.wvu.edu