Yang Junfeng,Xiao Minhui,He Zhengyu,Zhang Zhuorui,Shen Jie,Xiao Long,Yu Yanhong.Transumbilical laparoendoscopic single-site ureterolithotomy and nephrolithotomy: report of 18 cases[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(01):95-100.
Yang Junfeng,Xiao Minhui,He Zhengyu,Zhang Zhuorui,Shen Jie,Xiao Long,Yu Yanhong.Transumbilical laparoendoscopic single-site ureterolithotomy and nephrolithotomy: report of 18 cases[J].J Amry Med Univ (J Third Mil Med Univ),2017,39(01):95-100.DOI:
Transumbilical laparoendoscopic single-site ureterolithotomy and nephrolithotomy: report of 18 cases
Objective To investigate the application and operation skills of transumbilical laparoendoscopic single-site ureterolithotomy and nephrolithotomy. Methods Transumbilical laparoendoscopic single-ite ureterolithotomy and nephrolithotomy were performed in 18 patients (21 sides
5 males and 13 females
at a mean age of 35.5) in our hospital from May 2014 to May 2015. All the stones were solitary calculi
with an average maximum diameter of 2.5 cm. There were 13 stones at the upper of the ureter
2 stones at the bottom of the ureter
and 3 stones in the middle of the ureter. Five cases had infection or empyema. The patients were in lateral decubitus on the affected side (70°)
and then underwent a periumbilical Ushaped incision of 3 cm in size. Then a 1-ring 3-channel device was inserted for laparoscopy and ordinary laparoscopic instruments. A modified method was used to send D-J tube. The ureter was sutured intermittently
and improved knot tie was used to these surgeries. Results The surgery was successfully completed in all the patients. The average operation time was 97 min. The intraoperative bleeding amount was 15 mL. The average hospital length of stay was 3.5 d after surgery. The D-J stents were pulled out in 1~2 months after surgery
and then imaging reviews were taken. No ureteral and renal pelvis stricture and residual calculi was found. The wound healed well
and the outlook of the umbilical scar got 2.3 points averagely by Vancouver scar scoring. Conclusion For most cases with very large
impacted and multiple pelvic or ureteral stones
and being not suitable for ureteroscopic lithotripsy and percutaneous nephrolithotomy or those unlikely to succeed
transumbilical laparoendoscopic singlesite ureterolithotomy or nephrolithotomy is a good choice. Modified laparoscopic techniques improve the operation efficiency.