Abstract
Kidney stones presenting with abnormal renal anatomy offer a unique challenge to the urologist. The position, calyceal orientation, relationships of the calices to the renal pelvis, renal vasculature, relationships with other intraabdominal organs, and abnormal ureteral insertion of these kidneys vary significantly. We reported a rare case of staghorn stones in congenital malrotation double collecting kidney managed by laparoscopic extended pyelolithotomy. The procedure successfully achieved stone-free status without any complications. To summarize, laparoscopy is considered effective for complex renal stones with unusual anatomy, including double collecting systems and renal malrotation when percutaneous approach cannot be performed.