Laparoscopic - assisted percutaneous nephrolithotomy as an alternative in the treatment of complex renal calculi in patients with retrorenal colon.

We reviewed our prospective database of PNL in the last 5 years and identified all cases that underwent to LA-PNL. The option for choosing LA-PNL was made by the surgeon on the preoperative consultation based on the colon position on the CT scan. A 3-port laparoscopy was done for colon retrieval. Then, a percutaneous access guided by retrograde pyelography was performed, with direct visualization of the needle and dilators entrance. An ultrasonic device was used for stone fragmentation. A flexible nephroscopy was done at the end of the surgery. A nephrostomy tube was left in place and the trocars were removed.