The role of laparoscopy in the treatment of renal and ureteral calculi.
OBJECTIVE
We assessed the efficacy of laparoscopy in the treatment of renal and ureteral stones.


METHODS
Laparoscopic stone extraction was attempted in 11 men and 6 women 22 to 75 years old, including 6 with ureteral and 11 with renal calculi. Of the renal stones 9 were associated with a concomitant pathological condition requiring surgery. Four patients had multiple stones (2 to 93) and stone size ranged from 2 to 60 mm. (mean 15.6).


RESULTS
Stones from 15 of 17 patients were removed successfully via laparoscopic techniques. Operative time ranged from 2.33 to 6.35 hours (mean 4.9). Prolonged operating times were associated with ancillary or failed procedures. Blood loss ranged from 20 to 350 ml. (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.


CONCLUSIONS
Laparoscopic stone removal is safe and feasible. Indications for this approach include urinary stones associated with an anatomical abnormality requiring urinary tract reconstruction and calculi for which other minimally invasive therapies failed.
Micali
S
S
Brady Urological Institute, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA.
Moore
R G
RG
Averch
T D
TD
Adams
J B
JB
Kavoussi
L R
LR
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000628:therapy*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014514:Ureteral Calculi / Q000628:therapy*