Our experience with retroperitoneal laparoendoscopic single-site ureterolithotomy

Area of Science:

• Urology
• Minimally Invasive Surgery
• Endourology

Background:

• Large proximal ureteral stones pose a management challenge.
• Traditional surgical approaches can be invasive.

Purpose of the Study:

• To evaluate the feasibility and safety of retroperitoneal laparoendoscopic single-site (LESS) ureterolithotomy.
• To assess LESS ureterolithotomy for large proximal ureteral stones.

Main Methods:

• 20 patients with impacted upper ureteral stones (>15 mm) underwent retroperitoneal LESS ureterolithotomy.
• A reusable elastic single-port device and specialized instruments were utilized.
• The procedure mimicked conventional retroperitoneal laparoscopic ureterolithotomy.

Main Results:

• Successful completion of retroperitoneal LESS ureterolithotomy in all patients.
• Mean stone size was 18.8 mm; mean operative time was 108 minutes.
• No significant bleeding or major intraoperative complications; mean hospital stay was 4.4 days.

Conclusions:

• Retroperitoneal LESS ureterolithotomy is technically feasible and safe for large proximal ureteral stones.
• The use of a reusable single-port device is effective.
• Combining conventional and pre-bent laparoscopic instruments is a viable option for LESS procedures.