Laparoscopic Transmesenteric Pyelolithotomy in an Ectopic Pelvic Kidney with Partial Duplex System

Abstract Ectopic pelvic kidneys with associated anatomical anomalies present unique challenges for urolithiasis management. Conventional endourological approaches may be technically demanding in such cases. A 41-year-old female presented with intermittent lower abdominal pain. Imaging revealed a left ectopic pelvic kidney with a nondilated bifid pelvis and 15 mm × 10 mm calculus. A laparoscopic transmesenteric pyelolithotomy was performed, involving direct incision over the lower limb and calculus removal with ureteral stenting. Uneventful recovery and asymptomatic patient at subsequent follow-up. This case highlights the feasibility and safety of the laparoscopic transmesenteric approach in managing complex renal anomalies where conventional techniques may be challenging and advanced techniques, such as robotic surgeries either not available or nonaffordable.