LUMBOTOMY;

AN UNDER UTILIZED INCISION FOR RENAL AND UPPER URETERAL ACCESS

Abstract

Background: Urolithasis is a common urological ailment since antiquity. Treatment of urolithasis has witnessed a revolutionary
change with the advent of minimally invasive endoscopic techniques. However in developing countries very few cases of the renal stone
disease are being treated using minimally invasive techniques and vast majority are still being managed with open surgery. Objectives: The
objective of the study was to compare the two incisions used for renal and proximal ureter access, and find out which was better in our set up.
Methods: We carried out a study at our center, comprising of 50 cases of solitary renal stones, to compare the traditional oblique lumbar (OL)
incision with dorsal lumbotomy (DL). Patients included in the study were with a BMI of less than 30, all ages, having single large stone of renal /
proximal ureter, extra renal pelvis, no previous surgery on the ipsi-lateral side. Results: The study revealed that the lumbotomy incision is better
than the traditional lumbar oblique incision in terms of surgery time, post operative pain, early return to work and cosmetically accepted scar.
Conclusions: After analyzing the data we came to the conclusion that the lumbotomy incision was superior to the oblique lumbar incision in
selected cases and we recommend that it should be used specially in centers where facilities for endoscopic/minimally invasive management
are not available.