title: Laparoscopic urinary stone surgery: an updated evidence-based review.
abstract: The treatment of urinary lithiasis has been revolutionized during the last three decades. Minimally invasive therapies in the form of endoscopic surgery in companion with the advent of shock wave lithotripsy have diminished the role of open stone surgery. Laparoscopy, another minimally invasive treatment, is continuously gaining place in the treatment of urinary stones, mainly replacing open surgery. We have tried to identify the level of the evidence and grade of recommendation, according to the evidence-based medicine criteria, in studies supporting the laparoscopic approach to stone extraction. The highest level of evidence (IIa) was found for laparoscopic ureterolithotomy. It is technically feasible with the advantage of being minimally invasive and having lower postoperative morbidity compared to open ureterolithotomy. It is mostly recommended (grade B) for large impacted stones or when endoscopic ureterolithotripsy or shock wave stone disintegration have failed. Laparoscopic pyelolithotomy is feasible but rarely indicated in the present era (III/B). Laparoscopic nephrolithotomy may be indicated to remove a stone from an anterior diverticulum or when PNL or flexible ureteroscopy have failed (III/B).
authors.affiliation: Department of Urology, School of Medicine, Sismanoglio Hospital, University of Athens, Athens, Greece.
authors.forename: Andreas
authors.initials: A
authors.lastname: Skolarikos
authors.forename: Athanasios G
authors.initials: AG
authors.lastname: Papatsoris
authors.forename: Stefanos
authors.initials: S
authors.lastname: Albanis
authors.forename: Dean
authors.initials: D
authors.lastname: Assimos
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D010535:Laparoscopy; D014545:Urinary Calculi / Q000601:surgery*
references.citation: Ann Urol (Paris). 1995;29(2):61-72
references.pmid: 7646000
references.citation: Int J Urol. 2008 Mar;15(3):276-8
references.pmid: 18304232
references.citation: Int J Urol. 2004 Jul;11(7):581-4
references.pmid: 15242377
references.citation: J Endourol. 1999 Dec;13(10):723-5
references.pmid: 10646678
references.citation: J Urol. 2003 Feb;169(2):480-2
references.pmid: 12544292
references.citation: J Endourol. 2001 Jun;15(5):525-8
references.pmid: 11465333
references.citation: J Urol. 1997 Feb;157(2):463-6
references.pmid: 8996332
references.citation: Prog Urol. 2009 Mar;19(3):221-5
references.pmid: 19268263
references.citation: Int J Urol. 2006 Mar;13(3):206-10
references.pmid: 16643610
references.citation: Int J Urol. 2008 Jul;15(7):593-7
references.pmid: 18479354
references.citation: J Endourol. 2009 Nov;23(11):1851-6
references.pmid: 19619068
references.citation: J Urol. 1998 Aug;160(2):352-5
references.pmid: 9679875
references.citation: J Endourol. 2004 Aug;18(6):557-61
references.pmid: 15333221
references.citation: J Endourol. 2007 Jan;21(1):50-4
references.pmid: 17263607
references.citation: J Urol. 2002 Mar;167(3):1248-52
references.pmid: 11832707
references.citation: Eur Urol. 2001 Jul;40(1):32-6; discussion 37
references.pmid: 11528174
references.citation: J Endourol. 2009 Nov;23(11):1857-62
references.pmid: 19814700
references.citation: Prog Urol. 2008 May;18(5):281-7
references.pmid: 18538272
references.citation: Urol Int. 2005;75(4):322-6
references.pmid: 16327299
references.citation: Urol J. 2007 Summer;4(3):138-41
references.pmid: 17987574
references.citation: J Endourol. 2008 Jun;22(6):1251-5
references.pmid: 18578658
references.citation: BJU Int. 2008 May;101(10):1293-6
references.pmid: 18284405
references.citation: Chang Gung Med J. 2000 Jan;23(1):28-32
references.pmid: 10746407
references.citation: World J Urol. 2010 Feb;28(1):99-102
references.pmid: 19479265
references.citation: J Endourol. 2000 Dec;14(10):829-32
references.pmid: 11206616
references.citation: Indian J Urol. 2009 Jan;25(1):140-2
references.pmid: 19468448
references.citation: J Urol. 2002 Mar;167(3):1378-80
references.pmid: 11832737
references.citation: J Endourol. 2009 Jun;23(6):953-7
references.pmid: 19459753
references.citation: J Korean Med Sci. 2006 Jun;21(3):441-4
references.pmid: 16778386
references.citation: J Urol. 1994 Jan;151(1):146-9
references.pmid: 8254797
references.citation: J Urol. 1994 Jan;151(1):122-4
references.pmid: 8254787
references.citation: J Laparoendosc Adv Surg Tech A. 1997 Apr;7(2):95-8
references.pmid: 9459808
references.citation: J Laparoendosc Adv Surg Tech A. 2005 Apr;15(2):149-52
references.pmid: 15898906
references.citation: J Endourol. 2002 Nov;16(9):655-7
references.pmid: 12490018
references.citation: Int Urol Nephrol. 2003;35(1):73-6
references.pmid: 14620289
references.citation: J Endourol. 2001 Sep;15(7):701-5
references.pmid: 11697400
references.citation: Actas Urol Esp. 2009 Jun;33(6):621-2
references.pmid: 19711744
references.citation: J Urol. 2004 Aug;172(2):680-3; discussion 683
references.pmid: 15247760
references.citation: BJU Int. 2001 Nov;88(7):679-82
references.pmid: 11890236
references.citation: J Endourol. 2009 Nov;23(11):1867-70
references.pmid: 19811058
references.citation: J Endourol. 1993 Aug;7(4):315-7
references.pmid: 8252026
references.citation: Urol Res. 2009 Oct;37(5):257-60
references.pmid: 19572126
references.citation: BJU Int. 2005 Dec;96(9):1365-8
references.pmid: 16287459
references.citation: J Pak Med Assoc. 2006 Aug;56(8):381-3
references.pmid: 16967794
references.citation: J Laparoendosc Adv Surg Tech A. 2002 Aug;12(4):299-303
references.pmid: 12269502
references.citation: Int Braz J Urol. 2005 Mar-Apr;31(2):111-6
references.pmid: 15877829
references.citation: J Laparoendosc Adv Surg Tech A. 1998 Dec;8(6):431-5
references.pmid: 9916597
references.citation: Urology. 2006 Apr;67(4):828-9
references.pmid: 16584761
references.citation: Prog Urol. 2008 Dec;18(12):948-51
references.pmid: 19033058
references.citation: Scand J Urol Nephrol. 2004;38(3):263-5
references.pmid: 15204386
references.citation: J Endourol. 1996 Oct;10(5):425-30
references.pmid: 8905488
references.citation: Prog Urol. 2001 Sep;11(4):752-6
references.pmid: 11761704
references.citation: Int Braz J Urol. 2009 Jan-Feb;35(1):9-17; discussion 17-8
references.pmid: 19254393
references.citation: Urology. 2008 Apr;71(4):578-80
references.pmid: 18387386
references.citation: Urology. 2001 Apr;57(4):644-9
references.pmid: 11306369
references.citation: Curr Opin Urol. 2006 Mar;16(2):106-11
references.pmid: 16479213
references.citation: BJU Int. 1999 Nov;84(7):765-9
references.pmid: 10532968
references.citation: Urol Res. 2006 Jun;34(3):163-7
references.pmid: 16470391
references.citation: Urology. 1992 Mar;39(3):223-5
references.pmid: 1532102
references.citation: J Endourol. 2005 Apr;19(3):353-9
references.pmid: 15865527
references.citation: JSLS. 1997 Apr-Jun;1(2):163-5
references.pmid: 9876666
references.citation: J Urol. 2003 Feb;169(2):691-6
references.pmid: 12544344
references.citation: Tech Urol. 1998 Mar;4(1):29-34
references.pmid: 9568774
references.citation: Surg Endosc. 2004 Jul;18(7):1151
references.pmid: 15054649
references.citation: World J Urol. 2006 Jun;24(2):198-201
references.pmid: 16758250
references.citation: Surg Laparosc Endosc Percutan Tech. 2006 Dec;16(6):435-6
references.pmid: 17277663
references.citation: Eur Urol. 2001 Dec;40(6):609-13
references.pmid: 11805405
references.citation: Br J Urol. 1994 Aug;74(2):170-6
references.pmid: 7921933
references.citation: J Laparoendosc Adv Surg Tech A. 2009 Aug;19(4):501-4
references.pmid: 19670976
references.citation: J Med Assoc Thai. 1999 Oct;82(10):1028-33
references.pmid: 10561968
references.citation: J Urol. 1994 Apr;151(4):927-9
references.pmid: 8126827
references.citation: Curr Opin Urol. 2001 May;11(3):287-91
references.pmid: 11371782
references.citation: Int Urol Nephrol. 2006;38(1):75-8
references.pmid: 16502056
references.citation: Urol Int. 2004;73(3):234-7
references.pmid: 15539842
references.citation: Urol Int. 2008;80(3):306-9
references.pmid: 18480637
references.citation: J Urol. 1985 Apr;133(4):671-3
references.pmid: 3981721
references.citation: Int J Urol. 2009 Sep;16(9):713-7
references.pmid: 19674169