( Summary)
Purpose: to assess the safety and effectiveness of laparoscopic transperitoneal surgery and attempt to define it’s role in the management of ureteral and renal calculi
Patients and methods : laparoscopic transperitoneal surgery was undertaken in 32 patients ( male / female : 19/13 ) with calculous disease from 1/2005 to 4/2005 in the Hanoi French Hospital for variety of indications that otherwise would have made them candidates for conventional open surgery. The stone size ranges from 15-70mm ( mean 20,4 mm ). Some of this patients were subjected to transperitoneoscopic ureterolithotomy ( 26 patients ) and transperitoneoscopic pyelolithotomy ( 04 patients ), transperitoneoscopic diverticulolithotomy ( 02 patients ). The procedure were performed with two10 mm ports and two 5 mm ports. The JJ were useds for all patients.
Results : The procedure was successful in 100% cases. The mean operating time was 87 minutes, whereas it was 30 minutes for calcul pelvien ureteral. The average hospitalization was 3,1 days ( 2-6 days ). Non intra- operativ complication was encountered and no patient required a blood transfusion. There was no major postoperative complication, except prolonged sonde vesical in 01 patient
Conclusion : laparoscopic transperitoneal surgery has a definite role in the management of patients requiring open surgery for ureteral and special form of renal calculi. It is safe and realiable minimally invasive procedure.
Laparoscopic ureterolithotomy has definite advantages over open ureterolithotomy. Furthemore, the difficult a stone is for treatment by ESWL and endourological technique transperitoneal removal. For large, long-standing and impact ureteric calculi, one laparoscopic ureterolithotomy as initial therapy may be preferable to multiple endourological and ESWL procedures.