Retroperitoneal laparoscopic ureterolithotomy--a single centre 10 year experience

Area of Science:

• Urology
• Minimally Invasive Surgery

Background:

• Standard ureteric stone management includes ureteroscopy (URS), shock wave lithotripsy (SWL), and HO:YAG laser.
• Laparoscopic ureterolithotomy is an alternative for failed URS/SWL or large impacted stones.
• Retroperitoneal laparoscopic ureterolithotomy (RLU) offers a less invasive route compared to transperitoneal approaches.

Purpose of the Study:

• To share a decade of experience with retroperitoneal laparoscopic ureterolithotomy (RLU).
• To evaluate RLU as a primary or salvage procedure for ureteral calculi.
• To highlight RLU's efficacy in resource-limited settings.

Main Methods:

• A retrospective analysis of 126 RLU procedures for ureteral stones between January 2000 and January 2010.
• Indications included primary treatment for large impacted stones (68.25%), failed URS (22.23%), and failed SWL (9.52%).

Main Results:

• RLU achieved a 97.6% success rate with a mean operative time of 88 minutes.
• The most common complication was inadvertent peritoneotomy (11.9%).
• Mean hospital stay was 2.8 days, with 2.38% experiencing prolonged urinary drainage.

Conclusions:

• RLU is a highly effective, minimally invasive treatment for ureteral stones, achieving 100% stone clearance.
• It serves as a salvage procedure in advanced centers but can be a primary option in developing nations.
• RLU offers excellent results with minimal resources for upper and mid-ureteric stones.