A Novel Method for Retrograde Ureteral Stent Insertion During Laparoscopic Ureterolithotomy Without Radiological Guidance

TLDR: LU has been shown in small series to have the highest stone-free rate when comparing to extracorporeal shockwave lithotripsy (SWL) in the management of upper ureteral stone of >1 cm.

Abstract: Introduction: With the improvement in endoscopic techniques and shockwave lithotripsy, the role of laparoscopic ureterolithotomy (LU) has changed significantly over the past decade.1 LU remains a viable option for patients with large impacted upper ureteric stone which are less well treated by endoscopic methods. LU has been shown in small series to have the highest stone-free rate when comparing to extracorporeal shockwave lithotripsy (SWL) in the management of upper ureteral stone of >1 cm.2 In addition, LU has shorter hospitalization, shorter convalescence, and better analgesic profile compared with open ureterolithotomy.1 Various methods of intraoperative ureteric stent insertion during LU have been described but with varying reports on safety or efficacy.3–6 One of the challenges during LU is the laparoscopic insertion of ureteric stent into a small ureteric incision. This can be time consuming and technically challenging. Slippage of the guidewire or stent occurs commonly and their prolonge...