Ureterolithotomy Indications and Contraindications

Indications of laparoscopic ureterolithotomy include large, impacted, upper/mid/lower ureteric stones leading to obstruction, where other minimally invasive treatments have failed.

These patients have typically required open ureterolithotomy in the past. Smaller calculi are managed by endourologic techniques. Classically, the ureter is identified by visualizing ureteric peristalsis. The stone location is identified by seeing the stone bulge. Small ureteric stones are difficult to locate as the stone bulge may not be visible and no tactile feedback is provided by the laparoscopic approach. In such situations, intraoperative fluoroscopy or laparoscopic ultrasound may be very useful for stone localization.

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