LESS URETEROLITHOTOMY

Ahmed Abdalla , Mahmoud Abdel Hakim, Amr Abdel Hakim.
Urology Department, Cairo University, Cairo, Egypt


INTRODUCTION
AS the laparoendoscopic single site surgery(LESS) using a transumbilical access represents the closest surgical technique to scarless surgery we assess the feasibility of LESS in management of ureteral stones .

PATIENTS AND METHODS
Four cases of LESS ureterolithotomy were performed by a single laparoscopic surgeon. The indications for LESS ureterolithotomy were a stone size of ≥20 mm, an impacted stone or failure of endourological management. All procedures were done using SILS port that was inserted through a 20-30-mm umbilical incision. Patients age range was 36 to 44, BMI was less than 25 kg/m2.Articulating instruments were used.

RESULTS
Mean operative time was 87 minutes. Blood loss was less than 50 cc. The mean stone size was 22.4 mm. The stones were located in the upper ureter in two patients and in the middle ureter in the other 2 patients.Ureteral stent were fixed in all patients after stone remval.Pain score was between 1 to 2 in all patients. Mean hospital stay was 2 days. Uretheral catheter were removed after 5 days. No intra or post operative complications were encountered. No analgesics were required. Ureteral stent were removed after 4 weeks.

CONCLUSION
LESS ureterolithotomy is technically feasible procedure however a large number of cases is needed to establish its efficiency as a line of management.

 
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