Effects of Laparoscopic Ureterolithotomy and Simultaneous Trans-Trocar Semi-Rigid Ureteroscopy on Stone-Free Rate in the Treatment of Proximal Ureteral Stones

Objective\udThis study presents the effects of the use of semi-rigid ureteroscopy\udsimultaneously during laparoscopic ureterolithotomy on the stone-free\udrate and, the techniques used to perform laparoscopic ureterolithotomy\udless invasively.\udMaterials and Methods\udBetween November 2011 and July 2013, laparoscopic ureterolithotomy\udwas performed in 19 patients with proximal ureteral stones. A history of\udfailed shock wave lithotripsy (SWL) or semi-rigid ureteroscopy (sr-URS),\udpresence of ureter stones ≥15 mm and/or impacted stones, or a socioeconomic\udstatus not allowing the patient to reach an advanced center for\udflexible ureteroscopy (f-URS) were identified as the surgical indications.\udResults\udFourteen male (74%) and five female (26%) patients were enrolled in the\udstudy and the mean age was 36.4±15.11 (15-70) years. The stones were\udlocated on right side in five patients (26%) and left side in 14 patients\ud(74%). The mean stone size was 16.2±3.55 mm (8-22). The mean operation\udtime was 138.9±29.56 minutes (90-200). The mean urethral catheter and\uddrain removal time was 31.2±24.28 (16-120) and 50.8±33.61 hours (18-\ud168), respectively. There was no postoperative complication in long-term\udperiod and stone-free rate was 100%.\udConclusion\udLaparoscopic ureterolithotomy is a feasible alternative in a patient who had previously failed minimally invasive methods and/or with\udlarge impacted proximal ureteral stone. Furthermore, to use semi-rigid\udureteroscopy during the laparoscopic procedure increases the stonefree\udrate and prevents the need for an additional procedure in case of\udconcurrent presence of small kidney stones