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Laparoscopic ureterolithotomy: technical considerations and long-term follow-up
D D Gaur1, S Trivedi, M R Prabhudesai
1Department of Urology, Bombay Hospital Institute of Medical Sciences, Bombay, India.
BJU International
|March 2, 2002
Summary
Laparoscopic ureterolithotomy is a safe and effective minimally invasive treatment for ureteric stones. This retroperitoneal approach offers good long-term results, even for large, impacted stones, and can be considered a first-line option.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Ureteric stones pose a significant clinical challenge.
- Traditional treatments have limitations for complex cases.
Purpose of the Study:
- To evaluate the technical aspects and long-term outcomes of laparoscopic ureterolithotomy.
- To assess its efficacy in managing impacted ureteric stones.
Main Methods:
- Retrospective analysis of 101 patients undergoing laparoscopic ureterolithotomy (1991-2001).
- Predominantly retroperitoneal approach using Gaur's balloon retroperitoneoscopy.
- Inclusion of patients with large (mean 16 mm), chronically impacted stones.
Main Results:
- Successful treatment in 93% of patients.
- Mean operative time of 79 minutes.
- High complication rate (31%) primarily due to urinary leakage, reduced with stenting and suturing.
Conclusions:
- Retroperitoneal laparoscopic ureterolithotomy is a safe and reliable minimally invasive procedure.
- It is a valuable salvage option for failed treatments.
- Considered a first-line treatment for selected patients with large, impacted ureteric stones, especially those with solitary kidneys.