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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

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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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Related Experiment Video

Updated: Mar 13, 2026

Technical Modification of the Terminal Ureter During Total Transperitoneal Laparoscopic Nephroureterectomy for Upper Urinary Tract Urothelial Carcinoma
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Five-Year Single Center Experience for Retroperitoneoscopic Ureterolithotomy.

Yong Sung Won1, Seung-Ju Lee2, Hee Youn Kim2

  • 11 Department of Surgery, St. Vincent's Hospital, The Catholic University of Korea , College of Medicine, Suwon, South Korea .

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|October 22, 2016
PubMed
Summary

Retroperitoneoscopic ureterolithotomy effectively removes large upper ureteral stones. This minimally invasive technique offers a safe alternative, with optimized methods improving surgical efficiency and outcomes for impacted calculi.

Keywords:
calculicathetersretroperitoneoscopysuturetrocar

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Endourology

Background:

  • Narrow working space poses challenges in retroperitoneoscopic ureterolithotomy.
  • Evaluating the initial 5-year experience with this technique for large, impacted upper ureteral calculi.

Purpose of the Study:

  • To assess the safety and efficacy of retroperitoneoscopic ureterolithotomy for large impacted upper ureteral stones.
  • To present a standardized, step-by-step approach to facilitate the procedure in confined spaces.

Main Methods:

  • 37 patients with large impacted upper ureteral calculi underwent retroperitoneoscopic ureterolithotomy between 2011 and 2015.
  • Utilized a 12-mm camera port and two 5-mm working ports.
  • Employed ante grade Double-J catheter (DJC) placement and knotless unidirectional barbed suture for ureteral closure.

Main Results:

  • Successful stone removal in all cases without critical complications like ureteral stricture.
  • Mean operative time, DJC placement, and ureteral suturing times significantly decreased with experience.
  • Postoperative hospital stay averaged 3.2 days.

Conclusions:

  • Retroperitoneoscopic ureterolithotomy is a safe and effective treatment for large impacted upper ureteral stones.
  • The described step-by-step methods for port creation, DJC placement, and suturing aid surgeons in easily learning and performing the procedure.