Laparoscopic-endoscopic single-site surgery retroperitoneal ureterolithotomy: technique and initial experience
Volkan Tugcu1, Bircan Mutlu, Volkan Yollu
1Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey. volkantugcu@yahoo.com
Summary
Laparoscopic-endoscopic single-site retroperitoneal ureterolithotomy (LESS-RU) is a safe and feasible technique for removing large ureteral stones. This minimally invasive approach offers excellent cosmetic results with minimal scarring and quick recovery.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Endourology
Background:
- Laparoscopic-endoscopic single-site surgery (LESS) offers near scarless procedures.
- Retroperitoneal ureterolithotomy (RU) is a standard approach for ureteral stones.
- LESS-RU combines these techniques for improved outcomes.
Purpose of the Study:
- To evaluate the initial experience and technique of LESS-RU.
- To assess the safety and feasibility of LESS-RU for complex ureteral stones.
- To analyze outcomes including operative details, complications, and recovery.
Main Methods:
- Eighteen patients with large ( >15 mm) or impacted upper/middle ureteral stones, who failed prior interventions, underwent LESS-RU.
- Procedures were performed by a single experienced laparoscopist.
- Data collected included patient demographics, operative time, blood loss, stone size, analgesic use, and return to work.
Main Results:
- All 18 LESS-RU procedures were successful.
- Mean operative time was 69.9 minutes, with minimal blood loss (31.9 ml).
- Patients experienced good cosmetic results with minimal scarring and required oral analgesics for only two days postoperatively.
Conclusions:
- LESS-RU is a safe and feasible option for treating complex ureteral stones.
- The technique provides superior cosmetic results compared to traditional laparoscopic RU.
- Further comparative studies are warranted to establish LESS-RU as a preferred method.
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