Laparoendoscopic single-site surgery for ureterolithotomy: focus on intracorporeal stenting and suturing.
OBJECTIVE
To describe a technique of laparoendoscopic single-site surgery (LESS) for ureterolithotomy, focusing on intracorporeal stenting and suturing.


METHODS
From August 2009 to May 2010, 8 cases of LESS ureterolithotomy were performed by a single, experienced laparoscopic surgeon. The indications for LESS ureterolithotomy were a stone size of ≥15 mm, an impacted stone, intractable pain, or failure of previous treatment. All procedures were done using a platform homemade port device that was inserted through a 20-30-mm umbilical incision. We developed our own percutaneous stenting method and intracorporeal suture technique to suit the single port procedure. Additional ports and a stone retrieval bag were not needed.


RESULTS
All LESS ureterolithotomies were performed successfully without any complications. The mean stone size was 17.4 mm (range 11-24), and the stones were located in the upper ureter in all 8 patients. The mean operative time was 155.3 minutes (range 102-227), and the estimated blood loss was 37.5 mL (range <10-150). The mean postoperative time to stent removal was 3.4 weeks (range 1-4).


CONCLUSIONS
LESS ureterolithotomy using our technique was safe and effective, and the ureteral stenting and suturing techniques were a feasible alternative to those currently used for LESS.
Department of Urology, Urological Science Institute, Yonsei University College of Medicine, Seoul, Korea.
Kyung Hwa
KH
Choi
Seung Choul
SC
Yang
Jae Won
JW
Lee
Koon Ho
KH
Rha
Woong Kyu
WK
Han
D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D012189:Retrospective Studies; D015607:Stents; D013536:Suture Techniques; D014463:Ultrasonography; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000601:surgery*