Laparoscopic ureterolithotomy: minimally invasive second line treatment

Abstract

To describe our experience of 33 laparoscopic ureterolithotomies for large ureteral stones. Since February 2004, in our department, 33 patients had undergone laparoscopic ureterolithotomy. Inclusion criteria were failure of SWL and\or ureteroscopic treatment. Stones were located in the lower ureter in 9 patients, in the mid ureter in 16 patients, and in the upper ureter in 8 patients. Mean age of the patients was 47 years (range 37-51). The mean stone size, at preoperative IVP, was 34 mm (range 18-55). All stones were impacted from 4 to 36 months before procedure. Successful rates were 100%. No conversion to open surgery occurred. No intraoperative and postoperative complications occurred. Mean operating time was 85 min (range 60-160). Mean intraoperative blood loss was 70 ml (range 30-120). Mean hospital stay was 3.4 days (range 2-7). Mean follow-up was 24 months (range 6-44). During follow-up, no major complications were observed in any patients. In our hand, first-line treatment after failure of SWL and\ or ureteroscopy is laparoscopic ureterolithotomy. Large stone size and previous open surgery did not affect the successful rates of laparoscopic ureterolithotomy.