Retroperitoneoscopic Ureterolithotomy for the Treatment of Ureteral Calculi

Abstract

Introduction: Most upper or middle ureteral stones are treated with shock wave lithotripsy or endoscopic techniques. In rare cases the ureteral stones are treated with open surgery after failure of first-line treatments. Retroperitoneoscopy is a minimally invasive alternative to open surgery. Patients and Methods: Between May 1995 and January 2001, twenty-one patients underwent retroperitoneoscopic ureterolithotomy. The stones in upper and middle ureter were large and impacted (5 patients) or not fragmented after shock wave lithotripsy (16 patients). A balloon dissector was placed and infiltrated with 800 ml air in the retroperitoneal space. Three 10-mm trocars were used. The pressure was kept at 15 mm Hg by carbon dioxide insufflation. The stones were extracted from the ureter using a laparoscopic stylet. Results: The stones in 17 patients were successfully removed in a median operating time of 105 (min–max 45–190) min. Urine extravasation in all cases and pnomoscrotum in 2 cases were observed as postoperative complications. The median hospital stay was 6 (min–max 3–22) days with minimal analgesic requirement. Conclusion: Retroperitoneoscopic ureterolithotomy is a useful and effective alternative treatment technique to open surgery when first-line treatments have failed or are unlikely to be effective.

Comparative study on ureteroscopic lithotripsy and laparoscopic ureterolithotomy for treatment of unilateral upper ureteral stones

“…Besides, the experienced skills of surgeons were another important factor. In this study, following aspects were strictly performed to ensure Ureteral incision must be aligned, and enough ureteral lumen must be retained at saturation of muscular layer to avoid postoperative ureterostenosis 9 .…”

Laparoscopic versus open pyelolithotomy: our experience of 40 patients

“…6 In a 2004 study, Demirci et al observed that suturing of the ureter was more effective than placement of a double J stent to reduce urine extravasation. 7 Even though the case number was limited, the suturing in a non-inflamed ureter/pelvis was beneficial.…”

Complicaciones en cirugía laparoscópica urológica

“…Varios grupos han comunicado su experiencia en ureterolitotomía laparoscópica, reportando una baja tasa de complicaciones mayores. La filtración urinaria ha sido la complicación postoperatoria más frecuentemente informada [35][36][37] .…”