Purpose: Shock wave lithotripsy (SWL) and ureteroscopy are used to successfully manage the majority of ureteral stones. However, some large and impacted ureteral stones still require surgery. Laparoscopic ureterolithotomy has emerged as a feasible treatment option for the patients with large and impacted ureteral stone. Materials and methods: Between December 2004 and October 2005, laparoscopic ureterolithotomy was performed in 12 patients who required surgical treatment. In four patients, laparoscopy was carried as a salvage procedure after failed SWL, and laparoscopy was performed in seven patients as a primary procedure for treating large and impacted stones. The mean stone size was 16mm (range: 8-28). Results: All the procedures were completely laparoscopically, and all the patients were rendered stone-free after a single procedure; no complications were encountered. The mean operative time was 132.5 minutes (range: 60-220), and the mean estimated blood loss was 100ml (range: 50-150). The mean postoperative hospital stay was 4.3 days (range: 2-7). Conclusions: Laparoscopic ureterolithotomy can be a safe and effective treatment for large and impacted stones. In selected cases, it should be considered as a primary procedure for large and impacted ureteral stones that are located at the mid and upper levels of the ureter, including renal pelvic stones.
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