title: Our experience with retroperitoneal laparoendoscopic single-site ureterolithotomy.
abstract: OBJECTIVE
  To report our experience with retroperitoneal laparoendoscopic single-site (LESS) ureterolithotomy for the management of large proximal ureteral stones.
  
  
  METHODS
  From July 2011 to April 2012, 20 patients underwent retroperitoneal LESS ureterolithotomy. The indications for the operation were impacted upper ureteral stones larger than 15 mm. A reusable elastic single-port device with 3 working channels was inserted through the 2.5-cm incision at the midpoint between the costal arch and iliac crest on the mid-axillary line. A rigid 10-mm 30° extra-long laparoscope was introduced for monitoring, and a combination of lengthened pre-bent and conventional laparoscopic instruments was used for handling. The surgical procedure was similar to conventional retroperitoneal laparoscopic ureterolithotomy.
  
  
  RESULTS
  Retroperitoneal LESS ureterolithotomy was completed in all of the patients. The mean stone size was 18.8 mm (range 16-28). The mean operative time was 108 min (range 75-140). Significant bleeding was not observed, and no major intraoperative complications occurred in any of the patients. The mean hospital stay was 4.4 days (range 3-7).
  
  
  CONCLUSIONS
  Retroperitoneal LESS ureterolithotomy, using a reusable elastic single-port device, is technically feasible and safe, and the combination of conventional and pre-bent laparoscopic instruments represents an attractive option for retroperitoneal LESS.
authors.affiliation: Department of Urology, Hubei Provincial Corps Hospital, Chinese People's Armed Police Forces, Wuhan, China.
authors.forename: Zhonghua
authors.initials: Z
authors.lastname: Wu
authors.forename: Youming
authors.initials: Y
authors.lastname: Xu
authors.forename: Jianhua
authors.initials: J
authors.lastname: Yu
authors.forename: Jin
authors.initials: J
authors.lastname: Liu
authors.forename: Jiushun
authors.initials: J
authors.lastname: Chen
authors.forename: Shaoliang
authors.initials: S
authors.lastname: Wang
authors.forename: Kan
authors.initials: K
authors.lastname: Chen
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014514:Ureteral Calculi / Q000175:diagnosis / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D055815:Young Adult