Laparoscopic ureterolithotomy: is it an alternative technique replacing open surgery

ABSTRACT

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