Introduction and Objectives
The indication of laparoscopic surgery for ureter stones was restricted to the special cases, big size or impact stones. We presented special cases who underwent laparoscopic ureterolithotomy in various clinics.
Material and Methods
Forty-one patients were included to the study from 5 urology clinics in which routine laparoscopic surgery has been performing. Following history, physical examination, urine analysis, creatinin, intravenous urograpy, ultrasonograph, age, gender, stone size, hydronephrosis, previous ESWL, previous ureteroscopic stone therapy, laparoscopic approach, operation time, ureteric incision, insert double-j stent, amount of drainage, hospitalization period, complication were evaluated.
Results
Mean age was 41.8 in 30 male, 11 female patients. Mean ureter stone volume was 227.7 mm2. Retroperitonoscopic was preferred in 35, transperitoneal in 6. In 4, Grade (G) I, 22 GII, 12 GIII were detected. In 6, previuous ESWL was applied. Ureter was incised by cold knife in 5, scissor in 16, j-hook in 3, monopolar-bipolar cut in 17 patients. In 6 patients, double-j stent was inserted while in 1 operation was converted to open. Mean operation time was 124 minutes. Mean amount of drainage was 220 cc. Mean hospitalization time was 4.8 days. In 5 (12.5%) of 7, persistent drainage was detected as a major complication treated via insertion d-j stent. All patients were discharged as a stone free status.
Conclusions
Laparoscopic ureterolithotomy is a feasible and effective procedure especially for stones that could not treat easily with ureterocopic approach. Increased hospitalization and operation time could be related with difficulties of stone removal while success was achieved in each patient.
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Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
