Objectives: To report and discuss the role of the treatment of ipsilateral renal and upper middle ureteral stones in patients by combing retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy. Patients and Methods: Eleven patients associated with ipsilateral renal and upper middle ureteral stones underwent combing retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy after failure of shockwave or ureteroscopy lithotripsy. Their data were analyzed retrospectively including stone burden, perioperative complications and outcomes. Results: All the patients underwent retroperitoneal laparoscopic ureterolithotomy and tubeless mini-percutaneous nephrolithotomy successfully. Surgical time ranged from 80 to 160 min with a mean of 118 min. The mean hospital stay was 4 days (3-7 days). The mean length of retroperitoneal urinary drainage was 3 days (2-6 days). There were minor complications in 3 (27.2%) patients. The stone-free rate was 82% (9 patients). Two patients had a residual calyceal fragment that was treated with shockwave lithotripsy. All of them were followed up for 3-24 months. Renal function was improved in different degree. Conclusion: In carefully selected patients, combining retroperitoneal laparoscopic surgery with tubeless mini-percutaneous nephrolithotomy can treat ipsilateral renal and upper middle ureteral calculi by a single procedure with advantages of high stone-free rate, safety, reliability, rapid recovery and less complications.

Keywords:
Retroperitoneal laparoscopy, Percutaneous nephrolithotomy, Ureteral calculi, Tubeless
1.
Matlaga BR, Assimos DG: Changing indications of open stone surgery. Urology 2002;59:490-493.
2.
Wolf JS Jr, Clayman RV: Percutaneous nephrolithotomy: what is its role in 1997? Urol Clin North Am 1997;24:43-58.
3.
Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, Roemer FD, Pingleton ED, Thomson PG, Long SR: Laparoscopic nephrectomy: initial case report. J Urol 1991;146:278-282.
4.
Gaur DD: Retroperitoneal laparoscopic ureterolithotomy. World J Urol 1993;11:175-177.
5.
Raboy A, Ferzli GS, Ioffreda R, Albert PS: Laparoscopic ureterolithotomy. Urology 1992;39:223-225.
6.
Toth C, Holman M, Pasztor I, Khan AM: Laparoscopically controlled and assisted percutaneous transperitoneal nephrolithotomy in a pelvic dystopic kidney. J Endourol 1993;7:303-305.
7.
Holman E, Toth C: Laparoscopically assisted percutaneous transperitoneal nephrolithotomy in pelvic dystopic kidneys: experience in 15 successful cases. J Laparoendosc Adv Surg Tech A 1998;8:431-435.
8.
Gaur DD, Trivedi S, Prabhudesai MR, Madhusudhana HR, Gopichand M: Laparoscopic ureterolithotomy: technical considerations and long-term follow-up. BJU Int 2002;289:339-343.
9.
Micali S, Moore RG, Averch TD, Adams JB, Kavoussi LR: The role of laparoscopy in the treatment of renal and ureteral calculi. J Urol 1997;157:463-466.
10.
Liatsikos EN, Kapoor R, Lee B, Jabbour M, Barbalias G, Smith AD: ‘Angular percutaneous renal access'. Multiple tracts through a single incision for staghorn calculi treatment in a single session. Eur Urol 2005;48:832-837.
11.
Maheshwari PN, Bhandarkar DS, Shah RS, et al: Laparoscopy-assisted transperitoneal percutaneous nephrolithotomy for recurrent calculus in isthmic calyx of horseshoe kidney. J Endourol 2004;18:858-861.
12.
Wong C, Zimmerman RA: Laparoscopy-assisted transperitoneal percutaneous nephrolithotomy for renal caliceal diverticular calculi. J Endourol 2005;19:608-613.
13.
El-Kappany HA, El-Nahas AR, Shoma AM, El Tabey NA, Eraky I, El-Kenawy MR: Combination of laparoscopy and nephroscopy for treatment of stones in pelvic ectopic kidneys. J Endourol 2007;21:1131-1136.
14.
Limb J, Bellman GC: Tubeless percutaneous renal surgery: review of first 112 patients. Urology 2002;59:527-531.
15.
Wickham JE, Miller RA, Kellett MJ, Payne SR: Percutaneous nephrolithotomy: one stage or two? Br J Urol 1984;56:582-585.
16.
Bellman GC, Davidoff R, Candela J, Gerspach J, Kurtz S, Stout L: Tubeless percutaneous renal surgery. J Urol 1997;157:1578-1582.
17.
Aghamir SM, Hosseini SR, Gooran S: Totally tubeless percutaneous nephrolithotomy. J Endourol 2004;18:647-648.
18.
Shah HN, Kausik VB, Hegde SS, Shah JN, Bansal MB: Safety and efficacy of bilateral simultaneous tubeless percutaneous nephrolithotomy. Urology 2005;66:500-504.
19.
Mikhail AA, Kaptein JS, Bellman GC: Use of fibrin glue in percutaneous nephrolithotomy. Urology 2003;61:910-914.
20.
Lee DI, Uribe C, Eichel L, et al: Sealing percutaneous nephrolithotomy tracts with gelatin matrix hemostatic sealant: initial clinical use. J Urol 2004;171:575-578.
21.
Hoznek A, Herard A, Ogiez N, Amsellem D, Chopin DK, Abbou CC: Symptomatic caliceal diverticula treated with extraperitoneal laparoscopic marsupialization fulguration and gelatin resorcinol formaldehyde glue obliteration. J Urol 1998;160:352-355.
22.
Jou YC, Cheng MC, Sheen JH, Lin CT, Chen PC: Cauterization of access tract for nephrostomy tube-free percutaneous nephrolithotomy. J Endourol 2004;18:547-549.
23.
Chow GK, Patterson DE, Blute ML, Segura JW: Ureteroscopy: effect of technology and technique on clinical practice. J Urol 2003;170:99-102.
24.
Landman J, Lee DI, Lee C, Monga M: Evaluation of overall cost and currently available small flexible ureteroscopes. Urology 2003;62:218-222.
© 2012 S. Karger AG, Basel
2012
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