title: Experience sharing of retroperitoneal laparoscopic ureterolithotomy from a teaching hospital.
abstract: BACKGROUND
  Retro-peritoneal ureterolithotomy may be first option in impacted large upper and mid ureteric stones in selected cases.
  
  
  METHODS
  We performed 16 retroperitoneal laparoscopic ureterolithotomy in a teaching hospital. Out of 16 cases, eleven stones were located in the upper ureter and rest in mid ureter. Main indication was impacted large stone (1.5- 2cm) (1.72 cm, mean size). Failed extracorporeal shock wave lithotripsy and Uretero-renoscopy were other two indications. Failed PCNL for renal pelvic stone were resorted to open procedure not RUL.
  
  
  RESULTS
  Total 16 RUL were performed. Hospital stay in range was 3-11 days. The mean operative time was 96 minutes and mean blood loss was 30 ml. There were 4 failures. No major complications were encountered. Prolong urinary leakage was seen in one patient. Follow up Intravenous urogram at 3 months revealed normal ureter in all cases.
  
  
  CONCLUSIONS
  RUL is a good option in lieu of open surgery for selected patient with large hard impacted ureteral stone which are likely to resist any endo-urological procedure. Our experience represents a safe and effective treatment option as a first option for large impacted stone or as a salvage second option for failed endo-urological procedure or ESWL.
authors.affiliation: Department of surgery and urology, Kathmandu Medical College and Teaching Hospital, Kathmandu, Nepal.
authors.forename: R
authors.initials: R
authors.lastname: Joshi
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009390:Nepal; D012187:Retroperitoneal Space; D014514:Ureteral Calculi / Q000601:surgery*