Cirugía de puerto único transumbilical con instrumentos laparoscópicos convencionales en riñón en herradura / Transumbilical Single Port Surgery With Conventional Laparoscopic Instruments in Horseshoe Kidney

Introducción: La cirugía laparoscópica está teniendo una evolución natural a disminuir la agresión quirúrgica sobre la pared abdominal, sin merma de los resultados curativos y funcionales. Aunque en desarrollo, la cirugía monopuerto ha supuesto un avance en este sentido. Material y métodos: Presentamos la primera cirugía de pielolitectomía laparoscópica por puerto único en riñón en herradura, usando instrumentos rígidos convencionales. Paciente de 18 años con IMC de 19 que en las pruebas de imagen (urograma y tomografía computarizada) presenta un riñón en herradura con litiasis coraliforme izquierda y discreta ectasia calicial. Se extrae la litiasis mediante acceso umbilical con artilugio monopuerto e instrumentos rígidos convencionales. Resultados: La cirugía se completó sin complicaciones. El tiempo quirúrgico fue 110 min y el sangrado 50 cc. Al abrir el sistema urinario hubo extravasación de orina purulenta que condicionó fiebre en el postoperatorio de 38 ◦C. Durante la intervención se colocó catéter doble J por abordaje percutáneo. Fue dada de alta al tercer día de estancia. Conclusión: El acceso laparoscópico monopuerto para la cirugía de pielolitectomía en un riñón en herradura es una alternativa razonable. El uso de instrumentos convencionales rígidos facilita el desarrollo de esta cirugía con una buena triangulación, sin conflicto de manos y seguridad para el paciente (AU)

Introduction: Laparoscopic surgery is following a natural course as it decreases surgical aggression on the abdominal wall without undermining the curative and functional results. Although it is still being developed, single port surgery has meant an advance in this sense. Material and methods: We present the first single port laparoscopic pyelolithectomy surgery in horseshoe kidney, using conventional rigid instruments. The case of an 18-year old patient with BMI of 19 in whom the imaging tests (urogram and computed tomography) showed a horseshoe kidney with left coralliform lithiasis and discrete calyceal ectasia is presented. The lithiasis was extracted using umbilical access with single port device and conventional rigid instruments. Results: The surgery was performed without complications. Surgery time was 110 minutes and bleeding 50 cc. On incision of the urinary system, there was purulent urine extravasation that conditioned fever of 38 ◦C in the post-operatory period. During the intervention, a double J stent was placed via percutaneous approach. The patient was discharged on the third day of hospitalization. Conclusion: Single port laparoscopic access for pyelolithectomy surgery in horseshoe kidney isa reasonable alterative. The use of conventional rigid instruments facilitates the performance of this surgery with good triangulation, without conflict regarding hands and safety for the patient (AU)

Transumbilical single port surgery with conventional laparoscopic instruments in horseshoe kidney.

INTRODUCTION: Laparoscopic surgery is following a natural course as it decreases surgical aggression on the abdominal wall without undermining the curative and functional results. Although it is still being developed, single port surgery has meant an advance in this sense. MATERIAL AND METHODS: We present the first single port laparoscopic pyelolithectomy surgery in horseshoe kidney, using conventional rigid instruments. The case of an 18-year old patient with BMI of 19 in whom the imaging tests (urogram and computed tomography) showed a horseshoe kidney with left coralliform lithiasis and discrete calyceal ectasia is presented. The lithiasis was extracted using umbilical access with single port device and conventional rigid instruments. RESULTS: The surgery was performed without complications. Surgery time was 110 minutes and bleeding 50 cc. On incision of the urinary system, there was purulent urine extravasation that conditioned fever of 38 °C in the post-operatory period. During the intervention, a double J stent was placed via percutaneous approach. The patient was discharged on the third day of hospitalization. CONCLUSION: Single port laparoscopic access for pyelolithectomy surgery in horseshoe kidney is a reasonable alterative. The use of conventional rigid instruments facilitates the performance of this surgery with good triangulation, without conflict regarding hands and safety for the patient.