A Comparative Study Between Anterior and Posterior Pyelotomy in Transperitoneal Laparoscopic Pyelolithotomy

Overview

Large renal pelvic stones are frequently managed with percutaneous nephrolithotomy (PCNL) but laparoscopic pyelolithotomy (LPL) can be an alternative procedure when performed by skilled surgeons to achieve excellent outcomes in terms of stone free status, operative time, postoperative kidney function, hospitalization duration, and complications. there are two methods for LPL surgery : Transperitoneal (TLP) and Retroperitoneal (RLP). RLP associated with shorter mean time for oral intake, and mean hospital stay after surgery. The surgical exposure in the transperitoneal route for LP is familiar to the majority of surgeons. Also, a much larger working space is available and there are various established anatomical landmarks for performing the surgery effectively. This study introduces a modified technique that creates application of posterior pyelotomy in TLP to achieve the advantages of RLP

This is a randomized controlled clinical trial that aims to collect a sample within two years from the date of approval of the Scientific Research Council at Damascus University. The study will focus on a group of patients who will undergo a transperitoneal laparoscopic pyelolithotomy surgery. The patients will be randomly divided into two groups. The first group will undergo a traditional transperitoneal laparoscopic pyelolithotomy, which involves application of anterior pyelotomy. The second group will receive a modified transperitoneal laparoscopic pyelolithotomy, which involves application of posterior pyelotomy. The data will be compared between the two groups in terms of the mean duration of surgery ,mean time for oral intake ,and mean hospital stay