SYMPTOMATIC CALICEAL DIVERTICULA TREATED WITH EXTRAPERITONEAL LAPAROSCOPIC MARSUPIALIZATION FULGURATION AND GELATIN RESORCINOL FORMALDEHYDEGLUE OBLITERATION

Purpose: The treatment of symptomatic stone filled caliceal diverticul a has evolved from open surgery to less invasive procedures, such as e xtracorporeal shock wave lithotripsy, percutaneous techniques, retrogr ade ureteroscopy and laparoscopy, but it remains controversial. We des cribe a laparoscopic technique for the management of symptomatic calic eal diverticula. Materials and Methods: An extraperitoneal laparoscopi c procedure was done in 3 women with symptomatic caliceal diverticula, Watertight obliteration of the diverticular cavity was achieved witho ut suturing, using gelatin resorcinol formaldehyde glue. Results: Aver age operating time was 80 minutes, including ureteral catheterization. All patients became stone-free, there were no complications and avera ge hospital stay was 6.6 days. At 6-month followup the patients remain ed asymptomatic with no diverticula or stone recurrence. Conclusions: Retroperitoneoscopy allows safe access to caliceal diverticula regardl ess of location, and permits complete removal of stone and fulguration of the diverticular neck. Gelatin resorcinol formaldehyde glue minimi zes the risk of urinoma formation, and provides a simple, quick and sa fe alternative for nephrotomy closure.