Laparoscopic management of a left in situ calcified double j ureteral stent and a 2 cm ipsilateral kidney tumor
In this video we present a case of a 60 y.o. Caucasian male with a forgotten calcified double J ureteral stent, positioned 14 months ago in other department. A totally endoscopic resolution failed and only the cystolithotripsy with the detachment of the distal portion of the stent has been performed. A new double J stent has been placed to ensure the kidney drainage. While a previous x-ray examination didn’t show the encrusted double J stent, a CT scan showed the calcified upper loop of the old stent, the second double J stent plus the presence of two ipsilateral pelvic stones and a 2 cm polar inferior ipsilateral right incidental renal tumor.
The right renal pelvis was dissected, isolated and incised with a cold blade. The stent with 2.3 cm x 1.5 cm stone on the proximal tail was removed with the two ipsilateral stones.
The incision was closed longitudinally with 3-0 absorbable-barbed running suture.
The zero ischemia enucleation of the ipsilateral tumor was performed. The patient was discharged on postoperative day 3.
Endoscopic cystolithotomy combined with laparoscopic pyelolithotomy can be performed safely and successfully to remove the encrusted ureteral stent.