Laparoscopic decortication of symptomatic simple renal cysts

To investigate the technique and assess results of laparoscopic decortication of symptomatic simple renal cysts. Ten patients underwent trans-peritoneal laparoscopic decortication of symptomatic simple renal cysts. Complex renal cysts were excluded. Out of the 10 patients, 8 had undergone previous cyst aspiration with injection of sclerotic material for intended ablation. Out of these cysts, 8 were peripheral and 2 were peripelvic. The mean operative time was 116 +/- 37.7 minutes [range 90- 180] and blood loss was minimal. Symptomatic success was achieved in 9 patients with a mean follow up of 7 months [range 3-9], and radiologic success was achieved in 8 patients. Laparoscopic decortication of simple renal cysts is a safe and effective alternative to open surgery in patients who have failed conservative measures. Peripelvic cyst location makes laparoscopic decortications more challenging in the term of technical dissection yet feasible for the clinical outcome

Laparoscopic ureterolithotomy: is it an alternative technique replacing open surgery

To assess and evaluate the technique as a replacement to open surgical uretero-lithotomy. Fifteen patients with failed either ESWL or endoscopy and large calculi at the upper ureter were included in this study for performing transperitoneal laparoscopic uneterolithotomy Mean age was 47.2 7 +/- 9.32SD. 9 patients had right sided stones and 6 were left sided. Stone size range was 10-20 mm with mean 14.67 +/- 2.89 SD. 14 cases the stones were in the lumbar region and only 1 case at the iliac region. Successful laparoscopic stone removal were in 13 out of 15 [86.6%]. Two operative conversion to open surgery due to migration of stone in one case and in other conversion is due to injury of left common iliac artery. Operative times was 119.3 +/- 38.03 SD minutes [60-180min] estimated blood loss 62.3 +/- 11.6 [30-100] cc.. mean drain removal time was 3.4 days. mean post operative parentral analgesia was 150 mg of diclofenac sodium [75-300mg], mean hospital stay was 4.3 [3-8days] and mean resuming normal activity was 11.6[8-21 days]. Laparoscopic ureterolithotomy is a safe technique with a shorter hospital stay and rapid return to normal activity and offers an alternative modality than open surgery after treatment failure [ESWL, endoscopy] or for large size calculi. Open surgery has a role for managing laparoscopic converted cases