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Related Concept Videos

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
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Laparoscopic Ureterolithotomy with Concomitant Pyelolithotomy Using Flexible Cystoscope.

Selcuk Sahin1, Berkan Resorlu2, Feyzi Arda Atar3

  • 1Bakirköy Dr. Sadi Konuk Training and Research Hospital, Department of Urology, Istanbul, Turkey. urosahin@gmail.com.

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Summary

Laparoscopic ureterolithotomy with pyelolithotomy effectively treats upper ureteral and renal stones. This minimally invasive approach ensures complete stone clearance without open surgery conversion.

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Simultaneous upper ureteral and renal stones present a surgical challenge.
  • Effective treatment options are crucial for patient outcomes.

Purpose of the Study:

  • To evaluate the feasibility and efficacy of laparoscopic ureterolithotomy with concomitant pyelolithotomy.
  • To assess the use of a flexible cystoscope for simultaneous stone removal.

Main Methods:

  • 19 patients with ipsilateral upper ureteral and renal stones underwent the procedure.
  • Laparoscopic retroperitoneal approach with flexible cystoscope insertion via ureterotomy.
  • Stones were extracted using a nitinol basket or holmium laser lithotripsy.

Main Results:

  • All 19 procedures were completed laparoscopically with no open conversions.
  • Complete stone clearance was confirmed postoperatively in all patients.
  • Mean operative time was 86.5 minutes, with a slight increase for concomitant stone extraction.

Conclusions:

  • Laparoscopic ureterolithotomy with pyelolithotomy is a feasible and effective treatment.
  • This technique is suitable for patients with large ureteral stones and low renal stone burden.
  • The use of a flexible cystoscope facilitates simultaneous stone management.