Application of a temporary ureter clamp for retroperitoneal laparoscopic ureterolithotomy

Retroperitoneal laparoscopic ureterolithotomy is a new option to treat upper and middle ureter calculi in selected patients. However, migration of the stone and the flow of urine will influence the success.

We have developed a new and practical method using a clamp proximally above the stone to fix its position and prevent urine flow. Twenty patients had undergone retroperitoneal laparoscopic ureterolithotomy using this method. A bulldog artery clamp was used as the temporary clamp and was placed at the proximal part of the ureter during the procedures of incision, intubation and suture.

The average age of the patients was 42.5 years (range: 26-73) and the average stone size was 13.7 mm (range: 10-28). The average operating time was 38.2 min (range: 30-85). All target stones were successfully extracted without major complications. The average time of post-operation drain removal was 1.5 days. No case of prolonged urine leakage or ureter stricture was recorded.

We conclude that using a temporary ureter clamp is a feasible and practical method to fix the stone and minimize the difficulty of retroperitoneal laparoscopic ureterolithotomy.