Retroperitoneoscopic ureterolithotomy for impacted ureteral stones

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Open ureterolithotomy is rarely needed for ureteral stones due to advancements in extracorporeal shock wave lithotripsy and endourology.
• Retroperitoneoscopic ureterolithotomy, first performed in 1979, offers a less invasive option for select cases.

Purpose of the Study:

• To evaluate the efficacy and safety of retroperitoneoscopic ureterolithotomy for impacted ureteral stones.
• To assess outcomes in patients who failed other minimally invasive treatments.

Main Methods:

• Retroperitoneoscopic ureterolithotomy was performed in 5 patients with ureteral stones in 1997.
• Gaur's technique of balloon dissection for retroperitoneal space creation was utilized.

Main Results:

• Successful treatment in all 5 patients.
• Average operating time: 125 minutes; Average blood loss: 75 ml.
• No immediate complications; average hospital stay: 5.5 days. One patient developed ureteral stricture, successfully treated.

Conclusions:

• Retroperitoneoscopic ureterolithotomy is a practical alternative for selected ureteral stone cases.
• Impacted stones with chronic ureteritis can make the procedure challenging.
• Expertise is crucial for optimal results; a ureteral stricture may arise from pre-existing inflammation.