RESUMEN
Introduction: The use of minimally invasive techniques has helped decrease the morbidity and convalescence associated with the management of urolithiasis. In this regard laparoscopy has also developed as one of the modalities. However, in comparison with other surgeries, laparoscopy for stone removal is relatively uncommon. Here we present our experience of laparoscopic stone surgeries. Materials and methods: 10 patients with large renal and ureteric calculi where planned for laparoscopic surgery. Three patients had 2-3 cm proximal ureteric calculi, 2 patients had > 3cm renal pelvic calculi, 2 patients had multiple renal calculi associated with PUJ Obstruction, 2 patients had pelvic calculi in ectopic kidneys and one patient had calculus in crossed fused ectopia. Results: All the patients had a smooth intra-operative course. Post-operative period was uneventful except for one patient with crossed fused ectopia. One of the patients with PUJ obstruction had a single residual calculus which was managed with ESWL on follow up. Conclusions: Laparoscopic approach can be an effective alternative to endourological or open procedures for stone removal. It can be utilized for stone management in urinary tract where ESWL, PCNL and ureteroscopy have failed or deemed unsuitable. It is also a good option in patients with unusual anatomy such as ectopic kidney.
RESUMEN
A case of Central Pontine Myelinolysis and Extrapontine Myelinolysis presented with dystonia, Parkinsonism, and pathological crying that developed few days after gradual correction of hyponatremia. EEG slowing was evident before onset of symptoms, and disappeared with clinical improvement. Thalamic lesions alone produced these features. It dramatically responded to the Trihexyphenidyl therapy. Thus, basal ganglia involvement is not mandatory to produce this clinical picture; early onset of symptoms, resolution of EEG slowing and prompt response to anticholinergics may indicate better prognosis.