International Surgery Journal | August 2020 | Vol 7 | Issue 8 Page 2598 International Surgery Journal Prasad D et al. Int Surg J. 2020 Aug;7(8):2598-2604 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Laparoscopic pyelolithotomy: its current place in the management of renal pelvis stones Dinesh Prasad, Shivamshekhar Singh* INTRODUCTION Percutaneous nephrolithotomy (PCNL) is accepted as the gold standard surgery for most patients suffering from large or complex renal calculi. Despite its advantage in percutaneous approach with high stone free rate (SFR), some concerns still remain about its complications such as immediate or late hemorrhage (due to arteriovenous fistula or pseudo aneurysm), parenchymal loss and injury to the adjacent organs. 1 The ideal procedure for large or complex renal stones would be the one that achieve complete stone free status with minimal morbidity and with the least number of procedures. The traditional standard procedure was open nephrolithotomy, which evolved into PCNL or retrograde intrarenal surgery. 2 With the evolution of laparoscopy, a new era in the field of stone removal surgery is developing. Theoretically, ABSTRACT Background: Laparoscopic pyelolithotomy is assumed to preserve functional renal parenchyma, and there is a limited risk for immediate or late renal hemorrhage. Therefore, it might be an alternative for the patients in whom maximal preservation of renal parenchyma is necessary. In the present study, we aimed to compare the success rate and perioperative complications of laparoscopic pyelolithotomy. In the present study, we aimed to document and compare the success rate and perioperative complications of laparoscopic pyelolithotomy with published literature about percutaneous nephrolithotomy (PCNL). Methods: We retrospectively reviewed the clinical charts of all patients subjected to laparoscopic pyelolithotomy (18 cases) in the Department of General Surgery at SMIMER Hospital (tertiary care centre), Surat between the period of January 2014 to December 2018. Record of all patients were assessed for demographic profile, co morbidities, routine blood investigations, including RFT, urine cytology and culture sensitivity, specialized investigation as X-ray KUB, USG KUB, IVP/CT-Urography, DTPA scan, all patients were called for follow up evaluation with radiological, clinical and RFT studies at regular intervals upto 3 months. Results: LP is considered a successful alternative therapy for PCNL in selected cases with large renal stones like those in the extra renal pelvis in patients without a history of previous surgery. In addition, laparoscopic pyelolithotomy (LP) can be considered as a reasonable therapeutic option for large staghorn calculus which cannot be removed with a reasonable number of access and sessions of PCNL. Conclusions: Our results show that laparoscopic pyelolithotomy is equally good or better as compared to PCNL in selected cases. Keywords: LP, PCNL, Uretero pelvic junction obstruction Department of General Surgery, Surat Municipal Institute of Medical Education and Research, Surat, Gujarat, India Received: 29 April 2020 Revised: 02 July 2020 Accepted: 07 July 2020 *Correspondence: Dr. Shivamshekhar Singh, E-mail: drshivam793@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20203240