title: Outpatient double percutaneous endolaparoscopic extraction of large continent urinary reservoir stones--a new minimally invasive approach.
abstract: OBJECTIVE
  We report an efficient new method of managing massive stone burdens in continent urinary reservoirs without urethral access, using the minimally invasive double percutaneous endolaparoscopic technique.
  
  
  METHODS
  After first obtaining and dilating a percutaneous tract into the reservoir, a second access is established using a laparoscopic trocar under direct vision. Using endoscopic instruments, large stones are placed into a laparoscopic entrapment bag, fragmented (if necessary), and then transferred extracorporeally without any damage to the integrity or mucosa of the reservoir and without leaving behind any stone fragments.
  
  
  RESULTS
  This technique was used successfully in 5 of 5 patients with continent reservoirs, achieving stone-free status without short-term or long-term (mean follow-up 32.4 months, range 9-61 months) complications.
  
  
  CONCLUSIONS
  Double percutaneous endolaparoscopic stone extraction is a safe, effective, and minimally invasive method of managing continent urinary reservoir stones.
authors.affiliation: Department of Urology, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA.
authors.forename: Ricardo Aydar
authors.initials: RA
authors.lastname: Natalin
authors.forename: Keith
authors.initials: K
authors.lastname: Xavier
authors.forename: Ravi
authors.initials: R
authors.lastname: Kacker
authors.forename: Mantu
authors.initials: M
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D002137:Calculi / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011859:Radiography; D016476:Urinary Reservoirs, Continent / Q000473:pathology*