METHOD OF TREATING UROLITHIASIS IN L-SHAPED KIDNEYS

摘要

FIELD: medicine.SUBSTANCE: invention relates to medicine, specifically to urology. After the previously performed standard percutaneous nephrolithotripsy of vertical part of the L-shaped kidney under an endotracheal anesthesia, carboperitoneum is created, and the trocar is placed in parumbilical manner 1 cm below the umbilicus ∅ 10 mm. A laparoscope is introduced, the abdominal cavity is inspected, and four additional trocars are inserted: 2 cm below umbilicus – in right ∅ 5 mm and left ∅5 mm lateral regions along an abdominal rectus edge and 2–3 cm more medially than a flange of the ilium – in the right ∅ 5 mm and left ∅10 mm iliac regions. Further, after the parietal peritoneum is dissected and the intestinal loops are diverted, a horizontal portion of the L-shaped kidney is exposed. Pyelotomy and pyelolysis are performed. Further, 24Ch nephroscope is used to access calyxes through the right ports, and ultrasound calicolithotripsy with lithoextraction and aspiration of fragments is performed under laparoscopic control. After all the concrements are removed, pelvis defect is closed, an insurance drainage is installed, and trocars are closed under visual control, and the wound is sutured.EFFECT: method enables reducing the length of the surgical intervention, the duration of hospitalization and rehabilitation of the patient, is safe and has a good cosmetic effect.1 cl, 1 ex, 7 dwg