Laparoscopic ureterolithotomy: the Edinburgh experience

Objective To review our experience with laparoscopic ureterolithotomy. Patients and methods Since 1993, we have performed laparoscopic ureterolith otomy in 14 patients with ureteric stones. Laparoscopy was carried out in n ine patients as a salvage procedure after failed ureteroscopy (six), shock wave lithotripsy (two), or both tone), and in five patients as a primary pr ocedure for large stones (mean 27.2 mm, range 18-40). Patients in the forme r group had already undergone a mean of 1.88 procedures (range 1-4). Laparo scopic ureterolithotomy was carried out via a transperitoneal approach. Ass ociated ureteric strictures were incised at the time of ureterotomy. Results All procedures were completed laparoscopically and all patients wer e rendered stone-free after a single procedure, The mean operative duration was 105 rein. Ureteric strictures were incised in three patients, in two o f whom dilatation was subsequently required; all three had a successful res ult. There were three minor complications. Conclusions Laparoscopic ureterolithotomy can be a safe and effective proce dure; it should be considered as a primary procedure for large mid- and upp er ureteric stones.