Management of a Lost Stone During Laparoscopic Ureterolithotomy: Video Article
Journal Title: Translational Research in Urology - Year 2021, Vol 3, Issue 1
Abstract
Introduction Laparoscopic ureterolithotomy (LU) is a viable option for large ureteral stones (1, 2). The lost stone during laparoscopy is a rare event and most reports are in gallstone surgeries. Most experts recommended that the lost gallstone should be extracted from the abdominal cavity to prevent abscess formation but in laparoscopic ureterolithotomy with lost stone, the optimal management is controversial (3-5). We report our experience with a lost ureteral stone during laparoscopy and the technique that was successful to find it. Case presentation The patient was a 28-year-old man, who presented with a 22 millimetre stone in the proximal part of the left ureter. The spiral computed tomography scan revealed severe hydronephrosis. The patient was positioned on the left flank and the camera port was inserted in the lateral border of the rectus muscle then two 5 mm working ports were inserted in the left upper quadrant and left lower quadrant, respectively. The ureterolithotomy process was performed uneventfully with Double-J stent insertion, but during the extraction of the stone from the 10 mm port, the stone was lost in abdominal space due to rupture of our endobag (which was a finger of a surgical glove). We extract the lost stone by stepwise searching the dependent part of the abdominal cavity and found the stone in the dependent part of the right lower quadrant. The operative time was 165 minutes. The patient had no complications in the Post-operative course, the Foley catheter was removed on postoperative day 2 and the drain was removed on postoperative day 3. The patient was discharged home on post-operation day 4 and the stent was removed four weeks later. Conclusions We believe that any effort should be performed to extract lost stone in laparoscopic ureterolithotomy cases due to the potential risk of abscess formation and the probability of misleading imaging in the future follow-up of patients.
Authors and Affiliations
Alimohammad Fakhr Yasseri, Abdolreza Mohammadi, Seyed Mohammad Kazem Aghamir
Keywords
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- EP ID EP704076
- DOI 10.22034/TRU.2021.278483.1063
- Views 103
- Downloads 0
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