title: Laparoscopic stone surgery with the aid of flexible nephroscopy.
abstract: OBJECTIVE
  To report the outcome of laparoscopic pyelo- and ureterolithotomies with the aid of flexible nephroscopy.
  
  
  METHODS
  A retrospective analysis was performed in 71 patients with complex renal stones or large and impacted proximal ureteral stones. Patients underwent laparoscopic pyelo- or ureterolithotomies with or without the removal of small residual stones by use of flexible nephroscopy between July 2005 and July 2010. Operative success was defined as no residual stones in the intravenous pyelogram at 12 weeks postoperatively. Perioperative results and surgical outcomes were analyzed.
  
  
  RESULTS
  The patients' mean age was 54.7±13.7 years, and 53 males (74.6%) and 18 females (25.4%) were included. The mean maximal stone size was 19.4±9.4 mm. A total of 47 cases were complex renal stones and 24 cases were impacted ureteral stones. Mean operative time was 139.0±63.7 minutes. Stones were completely removed in 61 cases (85.9%), and no further ancillary treatment was needed for clinically insignificant residual fragments in 7 cases (9.9%). For complex renal stones, the complete stone-free rate and clinically significant stone-free rate were 80.9% and 93.6%, respectively. Multivariate analysis showed that the use of flexible nephroscopy for complex renal stones can reduce the risk of residual stones. A major complication occurred in one case, in which open conversion was performed.
  
  
  CONCLUSIONS
  Laparoscopic stone surgery is a safe and minimally invasive procedure with a high success rate, especially with the aid of flexible nephroscopy, and is not associated with procedure-specific complications.
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Jae Hyun
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Sung Yong
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Chang Wook
authors.initials: CW
authors.lastname: Jeong
authors.affiliation: Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Hyeon
authors.initials: H
authors.lastname: Jeong
authors.affiliation: Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Hwancheol
authors.initials: H
authors.lastname: Son
authors.affiliation: Department of Urology, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Seung Hyo
authors.initials: SH
authors.lastname: Woo
authors.affiliation: Department of Urology, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Dae Kyung
authors.initials: DK
authors.lastname: Kim
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Sun-Ho
authors.initials: SH
authors.lastname: Min
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Seung-June
authors.initials: SJ
authors.lastname: Oh
authors.affiliation: Department of Urology, Seoul National University Hospital, Seoul, Korea.
authors.forename: Hyeon-Hoe
authors.initials: HH
authors.lastname: Kim
authors.affiliation: Department of Urology, SMG-SNU Boramae Medical Center, Seoul, Korea.
authors.forename: Seung Bae
authors.initials: SB
authors.lastname: Lee
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods; D008297:Male; D008875:Middle Aged; D009403:Nephrostomy, Percutaneous / Q000379:methods*; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D055815:Young Adult
keywords: Cystoscopes; Kidney calculi; Laparoscopes; Ureteral calculi