INADVERTENT PUNCTURE OF THE KIDNEY BY A TROCAR DURING RETROPERITONEOSCOPIC URETEROLITHOTOMY

We report a case of inadvertent renal injury caused by a correctly pla ced trocar during retroperitoneoscopic ureterolithotomy. Tight adhesio ns between the kidney and posterior abdominal wail, caused by a pre-pl aced percutaneous nephrostomy tube, hindered the development of the wo rking space using a dissecting balloon. The renal bleeding caused by t he trocar puncture required open laparotomy for repair and the post-op erative course was uneventful. This case highlighted the importance of direct visual surveillance during trocar placement and awareness of t he difficulty of developing the retroperitoneal space in patients with a history of a percutaneous nephrostomy tube.