Laparoscopic transperitoneal ureterolithotomy

Abstract

Purpose: To present our experience with laparoscopic ureterolithotomy as a potential alternative to open ureterolithotomy.

Patients and methods: Between October 2003 and October 2005, a total of 27 laparoscopic ureterolithotomies were performed in 25 patients. The mean age of the patients was 39.8 +/- 17.5 years, and the mean body mass index (BMI) was 28.7 +/- 3.9 kg/m2. The inclusion criteria were stone(s) in the middle or upper ureter not suitable for treatment with SWL or endoscopy. Bilateral stones, multiple stones at the same level, recurrent stones, or stones in duplex systems were not a contraindication. A transperitoneal approach was used.

Results: The mean operative time was 145 +/- 42 minutes. The mean blood loss was 62.5 +/- 23 mL with mean hemoglobin decline of 0.78 +/- 0.31 g/dL. Postoperative analgesia was a single dose of a non-steroidal anti-inflammatory drug on day 1. The mean postoperative hospital stay was 4.1 +/- 6.7 days. No evidence of backpressure changes or increase in the serum creatinine concentration was observed during the follow-up. Assessment of the BMI, level of the stone, and laterality showed no statistical impact on the mean operative time.

Conclusions: Laparoscopic ureterolithotomy is technically feasible with the advantage of being minimally invasive and having lower postoperative morbidity.