THE ROLE OF LAPAROSCOPY IN THE TREATMENT OF RENAL AND URETERAL CALCULI

Purpose: We assessed the efficacy of laparoscopy in the treatment of r enal and ureteral stones. Materials and Methods: Laparoscopic stone ex traction was attempted in 11 men and 6 women 22 to 75 years old, inclu ding 6 with ureteral and 11 with renal calculi. Of the renal stones 9 were associated with a concomitant pathological condition requiring su rgery. Four patients had multiple stones (2 to 93) and stone size rang ed from 2 to 60 mm. (mean 15.6). Results: Stones from 15 of 17 patient s were removed successfully via laparoscopic techniques. Operative tim e ranged from 2.33 to 6.35 hours (mean 4.9). Prolonged operating times were associated with ancillary or failed procedures. Blood loss range d from 20 to 350 mi. (mean 132.9), narcotic requirement from 0 to 100 mg. morphine (mean 26) and hospital stay from 1 to 15 days (mean 4.5). The 3 postoperative complications included prolonged ileus (2) and a retroperitoneal urinoma requiring secondary drainage (1). Conclusions: Laparoscopic stone removal is safe and feasible. Indications for this approach include urinary stones associated with an anatomical abnorma lity requiring urinary tract reconstruction and calculi for which othe r minimally invasive therapies failed.