The use of laparoscopic pyelolithotomy was avidly contested with some authors extolling its virtues as an alternative to PCNL in medium-sized renal calculi unsuitable for SWL therapy and unfavorable calyceal anatomy (Gaur DD, Trivedi S, Prabhudesai MR, Gopichand M, J Laparoendosc Adv Surg Tech A 12(4):299–303, 2002 Yagisawa T, Ito F, Kobayashi C, Onitsuka S, Kondo T, Goto Y, Toma H, J Endourol 15(5):525–528, 2001) while others, though demonstrating its feasibility, were unable to show its superiority over PCNL vis-à-vis operative time and skill required, cosmesis and relative invasiveness (Goel A, Hemal AK, Int Urol Nephrol 35(1):73–76, 2003).The enhanced reconstructive capabilities of the robotic platform added another dimension to laparoscopic management of stone disease. Stones in anteriorly placed calyceal diverticulum, pelvic stones in ectopic kidneys, assisting percutaneous access in ectopic kidneys formed some of the other indications for laparoscopic stone interventions (Ramakumar S, Segura JW, J Endourol 14(10):829–832, 2000). Laparoscopic stone surgery soon gained acceptance as a complementary minimally invasive technique, specifically to be used in the occasional case considered for open surgery. While urolithiasis is largely treated with shock wave lithotripsy (SWL) and endourological surgery (ureteroscopy and percutaneous nephrolithotomy ), the role of laparoscopy has been explored as an alternative tool in managing urinary stone disease.Laparoscopic ureterolithotomy proved to be a viable alternative to open surgery, helping avoid incision related morbidity in candidates with impacted, large ureteral calculi which had failed an attempt at endourological management (Hemal AK, Goel A, Kumar M, Gupta NP, J Endourol 15(7):701–705, 2001). It has successfully been employed in kidney surgery as well, especially donor nephrectomy, partial nephrectomy, and pyeloplasty for ureteropelvic junction obstruction (UPJO) (Phillips CK, Taneja SS, Stifelman MD, J Endourol 19:441–445, 2005 Gettman MT, Neururer R, Bartsch G, Peschel R, Urology 60:509–513, 2002). It has particularly dominated urologic pelvic surgery including radical prostatectomy, radical cystectomy, and many gynecologic procedures (Menon M, Hemal AK, J Endourol 18(7):611–619, 2004 Hemal AK, Abol-Enein H, Shrivastava A, Shoma AM, Ghoneim MA, Menon M, Urol Clin North Am 31(4):719–729, 2004 Hemal AK, Kolla SB, Wadhwa P, J Urol 180(3):981–985, 2008]. Robotic surgery today has made a successful transition into mainstream clinical urological practice, providing minimally invasive surgical treatment options for complex extirpative and reconstructive procedures.
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