title: The initial experience of pneumovesicoscopic bladder stone removal using a laparoscopic entrapment sac.
abstract: BACKGROUND
  In this article, we aim to present our novel experience of bladder stone removal under pneumovesicoscopic field using a laparoscopic entrapment sac.
  
  
  METHODS
  We retrospectively reviewed the medical records of 21 patients who had pneumovesicoscopic bladder stone removal to assess a variety of patient characteristics and surgical outcomes. We considered stone burden, stone removal time including pneumovesicoscopic procedure time, postoperative catheter indwelling duration, postoperative hospital stay, and complications. The procedure was performed in the following steps: Under cystoscopy filled with saline solution, a 10-mm suprapubic transvesical trocar was inserted. After changing optical transmission medium from saline to CO(2) gas, pneumovesicoscopic procedure was performed to put stones in an entrapment sac inserted through the trocar. The stones trapped in the sac were extracorporeally broken with a lithotripter via the suprapubic route. The mean patient age was 58.95 ± 22.03 years. The mean stone burden was 4.88 ± 2.63 cm. Eleven patients had a single stone, whereas 10 had multiple stones. All stones were completely removed. The mean operative time was 31.66 ± 7.25 minutes, including the pneumovesicoscopic procedure time of 13.81 ± 7.30 minutes. In all but 6 patients with a cystostomy or a combined transurethral resection of the prostate, the urethra catheter was removed on the day after surgery; the mean postoperative hospital stay was 1.67 ± 0.49 days. There were 5 postoperative complications of Clavien grade I or II.
  
  
  CONCLUSIONS
  We report the technical feasibility of pneumovesicoscopic bladder stone removal using a laparoscopic entrapment sac as a minimally invasive method. This technique will likely become more important as a useful option for treating bladder stones.
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea.
authors.forename: Jae Seung
authors.initials: JS
authors.lastname: Hwang
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea. Electronic address: sjhwany@dmc.or.kr.
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Son
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea.
authors.forename: Seok Heun
authors.initials: SH
authors.lastname: Jang
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea.
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea.
authors.forename: Dae Sung
authors.initials: DS
authors.lastname: Cho
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea.
authors.forename: Chae Hong
authors.initials: CH
authors.lastname: Lim
authors.affiliation: Department of Urology, Bundang Jesaeng Hospital, Seongnam, Republic of Korea.
authors.forename: Dae Ji
authors.initials: DJ
authors.lastname: Kim
mesh_terms: D000368:Aged; D002404:Catheterization; D002408:Catheters, Indwelling; D003558:Cystoscopy / Q000379:methods; D003559:Cystostomy / Q000379:methods; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011470:Prostatic Hyperplasia / Q000601:surgery; D012189:Retrospective Studies; D020728:Transurethral Resection of Prostate; D016896:Treatment Outcome; D014521:Urethra / Q000601:surgery; D001744:Urinary Bladder Calculi / Q000601:surgery*