Laparoendoscopic single-site surgery for ureterolithotomy: focus on intracorporeal stenting and suturing

Abstract

OBJECTIVES: 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.