Advanced Stone Removal in Malrotated Ectopic Kidney – Excellence at Institute of Urology, Jaipur: A 45-year-old male presented to the Institute of Urology, Jaipur, with complaints of left flank pain. Imaging revealed two calculi in the left kidney – one measuring 11 mm in the renal pelvis and another 10.2 mm in the calyx region. The complexity of this case was heightened by the fact that the patient’s left kidney was ectopic and malrotated, located unusually in the left supraumbilical region.
Such anatomical anomalies pose significant challenges for surgical planning, especially when stone clearance is required. Traditionally, open or laparoscopic approaches could be considered, but these often come with increased morbidity, prolonged recovery, and visible scarring.
Clinical Decision and Planning
At the Institute of Urology, where minimally invasive urology is the standard of care, the case was evaluated by two of the country’s most renowned experts, Dr. Rajan Bansal and Dr. M. Roychowdhury.
Their priority was two-fold:
- To ensure complete stone clearance.
- To perform the procedure with minimal patient discomfort, no external scars, and rapid recovery.
After detailed counseling with the patient and family, the team planned a Retrograde Pyelography (RGP) followed by Retrograde Intrarenal Surgery (RIRS) with DJ stent placement. This approach utilized the Institute’s state-of-the-art endoscopic infrastructure, ensuring access to the malrotated kidney without any external incisions.
Procedure
- Under anesthesia, RGP was performed to delineate the altered anatomy of the ectopic kidney.
- Using a flexible ureteroscope, the team carefully navigated the urinary tract to reach the stones.
- Holmium laser lithotripsy was employed to fragment the stones into fine dust and small retrievable fragments.
- A DJ stent was placed to ensure smooth postoperative drainage and healing.
Remarkably, the entire procedure was completed without any abdominal incision, preserving the integrity of the abdominal wall and ensuring a completely scarless outcome.
Outcome
- All stones were cleared completely.
- The patient experienced minimal discomfort and was discharged the very next day.
- He was advised to return after 21 days for stent removal, by which time the urinary tract would be fully healed.
The patient expressed immense satisfaction, both with the rapid recovery and the fact that such a complex problem was solved without traditional invasive surgery.
Discussion
This case highlights the efficacy of the Institute of Urology, Jaipur in dealing with even the most complicated urological scenarios.
- The combination of world-class expertise, represented by Dr. Rajan Bansal and Dr. M. Roychowdhury, along with cutting-edge technology, makes it possible to handle anatomical challenges like malrotated and ectopic kidneys with ease.
- The philosophy of minimal access ensures that patients receive the highest standards of urological care—with quick recovery, no scars, and maximal comfort.
- The Institute stands as a one-stop center for advanced urology, equipped to deliver solutions for every kind of urinary stone disease, from simple to the most complex.
Conclusion
The successful management of this case reinforces the position of the Institute of Urology, Jaipur, as one of the best hospitals in India for advanced stone removal, especially in cases complicated by anatomical anomalies. With a blend of precision, planning, and minimally invasive expertise, patients are assured of safe, effective, and scarless treatment options.
