Laparoscopic ureterolithotomy: Technique, morphological and functional outcome in large ureteric calculi
Dinesh Prasad, Shivam Shekhar Singh
Introduction: Laparoscopic ureterolithotomy is an established alternative to open ureterolithotomy for the primary treatment of large, impacted, proximal or mid-ureteral stones or as salvage procedure for failed cases of extracorporeal shock wave lithotripsy and attempted ureterorenoscopy of stones in these locations. This study aimed to evaluate the efficacy and safety of laparoscopic transperitoneal ureterolithotomy for management of large proximal and mid-ureteric stones.Aims and Objectives: Tomeasure the efficacy of transperitoneal laparoscopic ureterolithotomy for management of large proximal and mid ureteric stones andimpact of this treatment onrenal function post-operatively.Materials and Methods: We retrospectively reviewed the clinical charts of all patients subjected to laparoscopic transperitoneal ureterolithotomy (cases) in the Department of General Surgery at SMIMER Hospital, Surat between the period of March 2014 to October 2018. Clinical charts of all patients were assessed for demographic profile, co-morbidities, routine blood investigations, including RFT, urine cytology and culture sensitivity and X ray KUB, USG KUB, IVP/CT-IVU,DTPA.Results: The mean operative time was 148±20 minutes with a mean blood loss of 50-60ml. The mean duration of hospital stay after surgery was 5±1 days, and the mean duration of stenting was 6-8 weeks. The stone clearance rate was 100% and no patient developed ureteric stricture. Conclusion:Transperitoneal laparoscopic ureterolithotomy is an effective and safer treatment option for reducing ureteral obstruction in patients with large proximal and mid-ureteric stones. Our results show that laparoscopic ureterolithotomy is better than open surgery in selected cases.