Abstract
BACKGROUND AND OBJECTIVE: Ureteropelvic junction obstruction and concomitant calculus disease may coexist. Therapeutic controversy exists regarding their ideal management. We report our use of flexible nephroscopy during laparoscopic pyeloplasty for caliceal stone removal. METHODS: From August 1998 through May 2002, 50 laparoscopic pyeloplasties were performed. Seven patients had documented ureteropelvic junction obstruction and ipsilateral nephrolithiasis. Preoperative stone burden and location were assessed. After pyelotomy, a 16 Fr flexible endoscope was passed through the uppermost trocar under direct laparoscopic guidance into the collecting system. Stone extraction was performed with a 2.4 Fr Nitinol basket. Postoperative imaging was assessed. RESULTS: Complete stone-free status confirmed by postoperative imaging was achieved in 6 of 7 patients. The longest individual stone diameter ranged from 4 mm to 13 mm (mean, 10.3 mm), and an average of 2.5 stones per patient was removed (range, 1 to 4 stones). Neither intraoperative fluoroscopy nor lithotripsy was required. No intraoperative or delayed complications were noted during a mean follow-up of 8.5 months (range, 2 to 17 months). CONCLUSIONS: Laparoscopic pyeloplasty and concomitant flexible nephroscopy with basket extraction is a simple, attractive alternative for the simultaneous treatment of ureteropelvic junction obstruction presenting with coexisting nephrolithiasis. It appears more efficacious when the stone number is limited and diameters measure from 5 mm to 20 mm.
| Original language | English |
|---|---|
| Pages (from-to) | 223-228 |
| Number of pages | 6 |
| Journal | JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons |
| Volume | 8 |
| Issue number | 3 |
| State | Published - Jan 1 2004 |
| Externally published | Yes |
Fingerprint
Cite this
Laparoscopic pyeloplasty and flexible nephroscopy : simultaneous treatment of ureteropelvic junction obstruction and nephrolithiasis. / Ball, Adam J.; Leveillee, Raymond J.; Patel, Vipul R.; Wong, Carson.
In: JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons, Vol. 8, No. 3, 01.01.2004, p. 223-228.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Laparoscopic pyeloplasty and flexible nephroscopy
T2 - simultaneous treatment of ureteropelvic junction obstruction and nephrolithiasis.
AU - Ball, Adam J.
AU - Leveillee, Raymond J.
AU - Patel, Vipul R.
AU - Wong, Carson
PY - 2004/1/1
Y1 - 2004/1/1
N2 - BACKGROUND AND OBJECTIVE: Ureteropelvic junction obstruction and concomitant calculus disease may coexist. Therapeutic controversy exists regarding their ideal management. We report our use of flexible nephroscopy during laparoscopic pyeloplasty for caliceal stone removal. METHODS: From August 1998 through May 2002, 50 laparoscopic pyeloplasties were performed. Seven patients had documented ureteropelvic junction obstruction and ipsilateral nephrolithiasis. Preoperative stone burden and location were assessed. After pyelotomy, a 16 Fr flexible endoscope was passed through the uppermost trocar under direct laparoscopic guidance into the collecting system. Stone extraction was performed with a 2.4 Fr Nitinol basket. Postoperative imaging was assessed. RESULTS: Complete stone-free status confirmed by postoperative imaging was achieved in 6 of 7 patients. The longest individual stone diameter ranged from 4 mm to 13 mm (mean, 10.3 mm), and an average of 2.5 stones per patient was removed (range, 1 to 4 stones). Neither intraoperative fluoroscopy nor lithotripsy was required. No intraoperative or delayed complications were noted during a mean follow-up of 8.5 months (range, 2 to 17 months). CONCLUSIONS: Laparoscopic pyeloplasty and concomitant flexible nephroscopy with basket extraction is a simple, attractive alternative for the simultaneous treatment of ureteropelvic junction obstruction presenting with coexisting nephrolithiasis. It appears more efficacious when the stone number is limited and diameters measure from 5 mm to 20 mm.
AB - BACKGROUND AND OBJECTIVE: Ureteropelvic junction obstruction and concomitant calculus disease may coexist. Therapeutic controversy exists regarding their ideal management. We report our use of flexible nephroscopy during laparoscopic pyeloplasty for caliceal stone removal. METHODS: From August 1998 through May 2002, 50 laparoscopic pyeloplasties were performed. Seven patients had documented ureteropelvic junction obstruction and ipsilateral nephrolithiasis. Preoperative stone burden and location were assessed. After pyelotomy, a 16 Fr flexible endoscope was passed through the uppermost trocar under direct laparoscopic guidance into the collecting system. Stone extraction was performed with a 2.4 Fr Nitinol basket. Postoperative imaging was assessed. RESULTS: Complete stone-free status confirmed by postoperative imaging was achieved in 6 of 7 patients. The longest individual stone diameter ranged from 4 mm to 13 mm (mean, 10.3 mm), and an average of 2.5 stones per patient was removed (range, 1 to 4 stones). Neither intraoperative fluoroscopy nor lithotripsy was required. No intraoperative or delayed complications were noted during a mean follow-up of 8.5 months (range, 2 to 17 months). CONCLUSIONS: Laparoscopic pyeloplasty and concomitant flexible nephroscopy with basket extraction is a simple, attractive alternative for the simultaneous treatment of ureteropelvic junction obstruction presenting with coexisting nephrolithiasis. It appears more efficacious when the stone number is limited and diameters measure from 5 mm to 20 mm.
UR - http://www.scopus.com/inward/record.url?scp=7044270907&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=7044270907&partnerID=8YFLogxK
M3 - Article
VL - 8
SP - 223
EP - 228
JO - Journal of the Society of Laparoendoscopic Surgeons
JF - Journal of the Society of Laparoendoscopic Surgeons
SN - 1086-8089
IS - 3
ER -