Laparoscopic Assisted Percutaneous Nephrolithotomy for Renal Pelvis Stone in a Crossed Fused ectopic Kidney: A Case Report

Crossed Renal Ectopia (CRE) is a relatively rare congenital renal anomaly. Management of stones formed within such anomalous renal architecture is a challenge for urological surgeons especially in the fused form of the anomaly (CFRE). There is an increasing trend for using percutaneous nephrolithotomy (PCNL) in such complicated cases. However, certain anatomical variants of this anomaly will make PCNL technically difficult especially when the path to the diseased kidney is blocked by the normal one. In this clinical report, we present a case of renal pelvis stone in a CFRE patient whose target pelvis position was technically difficult to reach by the fluoroscopy guided PCNL technique alone. To circumvent this difficulty, we successfully made use of the laparoscopic technology to visually navigate our way while creating the tract for the PCNL scope sheath in to the target renal pelvis.