Technique Modifications in Retroperitoneoscopic Ureterolithotomy for Impacted Upper

Abstract

Retroperitoneoscopic ureterolithotomy was successfully performed in five of seven patients with calculi impacted in the upper ureter. Our modifications of previously reported procedures included well adjustment of the position of the double-J ureteral stent under direct vision during the retroperitoneoscopic surgery without further posture change and suturing the ureterotomy incision with intracorporeal knotting. All these 5 patients were discharged without carrying ex-ternal tubes or bags. Peri- operative parameters in these successful cases were compared with those in 10 cases of traditional open ureterolithotomy. The average operative time was shorter (2.1 vs. 3.45 hours; P< 0.05) for the open ureterolithotomy group. The amount of mean blood loss did not differ between these two groups. The need for post-operative parenteral analgesics (60 vs. 175 mg of meperidine hydrochloride) was less; and post-operative hospital stay (3 .8 vs. 8.9 days) and convalescence to regulao daily activities (9.5 vs. 24 days) were much faster in the retroperitoneoscopic group (all P< 0.05). Retroperitoneoscopic ureterolithotomy, with its mini-mal invasiveness, is a valuable alternative in the management of upper ureteral stones, especially when open ureterolithotomy is indicated. (J Urol R.O.C., 9:186- 190, 1998)