Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access


Aim: to evaluate the possibilities and efficiency of using 3D technologies for the laparoscopic interventions in patients with renal and ureteric stones. Materials and methods. A retrospective analysis of the results of surgical treatment of patients with renal and ureteric stones performed in the urology clinic of the I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia for the period from January 2012 to December 2017 was carried out. During this period a total of 4958 interventions were done. Among them, 98 laparoscopic (1.97%) surgeries were performed, including nephron-sparing interventions (n=47; 48%), pyelolithotomy (n=15; 15.3%), ureterolithotomy (n=32; 32.65%) and partial nephrectomy (n=4; 4.05 %). The average patients’ age was 55.76±10.5 (29-80) years. There were 51 men (52%) and 47 women (48%). The mean stone density was 1237.6±354.6 HU (from 500 to 1913 HU). In 14 (22.9%) cases, nephrostomy tube or ureteric stent had been put before surgery. In addition, 40 (40.8%) patients previously underwent one surgical intervention on the kidneys and 17 patients with urinary stone disease (17.3%) underwent surgery ≥ 2 times. 88 (89.8%) patients had severe concomitant diseases and the most common pathology in 51 (52.0%) patients with urinary stone disease was arterial hypertension. In 11 (11.2%) cases, the interventions were performed in patients with abnormal kidneys, including horseshoe kidney (n=6; 6.1%), duplicated collecting system (n=3; 3.1%) and pelvic kidney (n=2; 2%). In addition to standard preoperative diagnostic methods in 22 cases (22.4%) the 3D-planning and multivariate virtual performing of intervention based on the multidetector computer tomography scan was done using Amira 3D-modeling program. Among these patients, virtual interventions were performed prior to all pyelolithotomy and partial nephrectomy. Intraoperative data of virtual constructions were used by surgeons as navigation. The interventions were performed by seven urologists at the clinic with various experience in laparoscopic surgery. Results. The mean duration of laparoscopic pyelolithotomy, laparoscopic partial nephrectomy, laparoscopic ureterolithotomy and laparoscopic nephrectomy was 183.2±69.6, 201.3±35.2 min, 97.6±43.7 and 165.4±92.3 min, respectively. The minimal blood loss was observed during laparoscopic ureterolithotomy (53.33+31.2 ml). During these interventions, in 8 cases (8.16%) a flexible endoscope was used for inspection and complete removal of stones. Intraoperative complications were noted in 6 patients (6.1%). There were 4 conversions to open surgery (4.1%). Postoperative surgical complications were observed in 1 (1%) patient, while non-surgical complications developed in 4 patients (4.1%). There was no mortality. Conclusion. Laparoscopic access for the treatment of patients with urinary stone disease should be used for the treatment of patients with large, long-standing ureteral calculi and patients with kidney stones who have concomitant pathology of kidney or upper urinary tract (UPJ obstruction, kidney tumors) requiring surgical intervention. Laparoscopic access should be considered primarily for the planning of laparoscopic partial nephrectomy and laparoscopic nephrectomy in patients with urinary stone disease. The use of 3D computer-assisted technologies is advisable for patients with urinary stone disease and abnormal kidneys if laparoscopic pyelolithotomy, partial nephrectomy or ureterolithotomy is planned

Full Text

Restricted Access

About the authors

Yu. G Alyaev

FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia

Email: ugalayev@mail.ru
Department of urology, corresponding member of RAS, MD, professor Moscow, Russia

E. S Sirota

FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia

Email: essirota@mail.ru
Urologic clinic, MD, Head of Surgical Unit of Urologic clinic, MD, Head of Surgical Unit of Urologic clinic Moscow, Russia

E. A Bezrukov

FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia

Email: eabezrukov@rambler.ru
MD, professor, Head of Urologic Department №1 of Urologic clinic Moscow, Russia

S. H Ali

FGAOU VO I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia

Email: nabilali095@gmail.com
Urologic clinic, Institute for Urology and Human Reproductive Health, Ph.D., senior researcher Moscow, Russia


  1. Khan S.R. et al. Kidney Stones. Nat Rev Dis Primers. 2016;2:16008.
  2. Curhan G.C. Epidemiology Of Stone Disease. Urol Clin North Am. 2007;34(3):287-293.
  3. Ramello A, Vitale C, Marangella M. Epidemiology of nephrolithiasis. Journal of nephrology 2000;13 Suppl 3:S45-50.
  4. Alyaev Yu.G., Rapoport L.M., Rudenko V.I. Urinary stone disease. Actual issues of diagnosis and treatment. Vrachebnoe soslovie. 2004. Р. 4-9.
  5. Romero V., Akpinar H., Assimos D.G. Kidney Stones: A Global Picture Of Prevalence, Incidence, And Associated Risk Factors. Rev Urol. 2010;12(2-3):Е86-96.
  6. Alyaev Yu.G., Glybochko P.V. Urinary stone disease. Current view on the problem. Guide for physicians. M.: Medforum. 2016. 148 p.
  7. Alyaev Yu.G., Rudenko V.I., Filosova E.V. Current aspects of medical treatment of patients with urinary stone disease. RMJ. 2004. Р. 534.
  8. Kaprin A.D., Apolikhin O.I., Sivkov A.V. Analysis of uronephrological morbidity and mortality in the Russian Federation for the period 2003-2013 yy. Eksperimental’naya i klinicheskaya urologiya. 2015. Р. 4-12.
  9. Hruza M., et al. Laparoscopic Techniques For Removal Of Renal And Ureteral Calculi. J Endourol. 2009;23(10):1713-1718.
  10. Glybochko P.V., Alyaev Yu.G. 3D-technologies for kidney surgery: from virtual to real surgery. M.:Geotar-Media. 2014. с. 10, 63-66, 91.
  11. Thiruchelvam N., Mostafid H., Ubhayakar G. Planning Percutaneous Nephrolithotomy Using Multidetector Computed Tomography Urography, Multiplanar Reconstruction And Three-Dimensional Reformatting. BJU INT. 2005;95(9):1280-1284.
  12. Dalela D., et al. Three-Dimensional Synchronized Multidirectional Renal Pyelo-Angiography: A New Imaging Concept To Facilitate Percutaneous Nephrolithotomy In Technically Challenging Cases. J Endourol. 2009;23(12):1937-1939.
  13. Rassweiler J.J., et al. Ipad-Assisted Percutaneous Access To The Kidney Using Marker-Based Navigation: Initial Clinical Experience. Eur Urol. 2012;61(3):628-631.
  14. Li H., et al. Construction Of A Three-Dimensional Model Of Renal Stones: Comprehensive Planning For Percutaneous Nephrolithotomy And Assistance In Surgery. World J Urol. 2013;31(6):1587-1592.
  15. Herts B.R. Role Of Three-Dimensional Imaging In Surgical Planning For Kidney Surgery. BJU Int. 2005;95(Suppl 2):16-20.
  16. Isotani S. et al. Feasibility And Accuracy Of Computational Robot-Assisted Partial Nephrectomy Planning By Virtual Partial Nephrectomy Analysis. Int J Urol. 2015;22(5):439-446.
  17. Gandaglia G., et al. Novel Technologies In Urologic Surgery: A Rapidly Changing Scenario. Curr Urol Rep. 2016;17(3):19.
  18. Ahmadi H., Liu J.J. 3-D Imaging And Simulation For Nephron Sparing Surgical Training. Curr Urol Rep. 2016;17(8):58.
  19. Porpiglia F., et al. Current Use Of Three-Dimensional Model Technology In Urology: A Road Map For Personalised Surgical Planning. Eur Urol Focus, 2018.
  20. Wang Z., et al. Application Of Three-Dimensional Visualization Technology In Laparoscopic Partial Nephrectomy Of Renal Tumor: A Comparative Study. J Laparoendosc Adv Surg Tech A. 2017;27(5): 516-523.
  21. Alyaev Yu.G., Glybochko P.V., Pushkar D.Yu. Russian clinical guidelines on urology. M.: Geotar-Media. 2016. 496 p.
  22. Assimos D., et al. Surgical Management Of Stones: American Urological Association/Endourological Society Guideline, Part I. J Urol. 2016;196(4):1153-1160.
  23. Turk C. et al. Eau Guidelines On Interventional Treatment For Urolithiasis. Eur Urol. 2016;69(3):475-482.
  24. Rui, X., et al. Comparison Of Safety And Efficacy Of Laparoscopic Pyelolithotomy Versus Percutaneous Nephrolithotomy In Patients With Large Renal Pelvic Stones: A Meta-Analysis. J Investig Med. 2016;64(6):1134-1142.
  25. Wang X., et al. Laparoscopic Pyelolithotomy Compared To Percutaneous Nephrolithotomy As Surgical Management For Large Renal Pelvic Calculi: A Meta-Analysis. J Urol. 2013;190(3):888-893.
  26. Miller J., et al. Renal Calyceal Anatomy Characterization With 3-Dimensional In Vivo Computerized Tomography Imaging. J Urol.2013;189(2):562-567.
  27. Brehmer M., Beckman M.O., Magnusson A. Three-Dimensional Computed Tomography Planning Improves Percutaneous Stone Surgery. Scand J Urol. 2014;48(3):316-323.
  28. Tailly T., Denstedt J. Innovations In Percutaneous Nephrolithotomy. Int J Surg. 2016;36(Pt D):665-672.
  29. Yoshida K. et al. Laparoscopic Upper-Pole Heminephrectomy For Duplicated Renal Collecting System With Superselective Artery Clamping Using Virtual Partial Nephrectomy Analysis Of Synapse Vincent: A Case Report. Int J Urol. 2015;22(11):1075-1077.
  30. Salvado J.A., et al. Laparoscopic Pyelolithotomy: Optimizing Surgical Technique. J Endourol. 2009;23(4):575-578.
  31. Borofsky M.S., Lingeman J.E. The Role Of Open And Laparoscopic Stone Surgery In The Modern Era Of Endourology. Nat Rev Urol. 2015;12(7):392-400

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies