Abstract
Introduction and Objective:
Massive stone burdens in continent urinary diversions are usually treated with open surgery since endoscopic techniques are cumbersome and may leave residual fragments. We report an efficient new method utilizing the minimally invasive double percutaneous endo-laparoscopic technique.
Patients and Methods:
After first obtaining and dilating a percutaneous tract into the reservoir, a second access is established using a laparoscopic trocar or balloon dilating system under direct vision. Using endoscopic instruments, large stones are placed into a laparoscopic entrapment bag, fragmented (if necessary), and then transferred extracorporeally without any damage to the integrity or mucosa of the reservoir and without leaving behind even a single fragment. After the removal of all the stones, the nephrostomy tube is placed. The tube is then clamped, and intermittent catheterization of the stoma is restarted. If there are no problems, the cystostomy tube is removed in 5 to 7 days during a postoperative visit.
Results:
This technique was utilized in all five patients with continent reservoirs, achieving stone-free status without short-term or long-term complications (mean follow-up, 32.4 months; range, 9–61 months). Nod damage to catheterizable channels occurred.
Conclusion:
Double percutaneous endo-laparoscopic stone extraction is a safe, effective, and minimally invasive method of treating continent urinary reservoir stones.
No competing financial interests exist.
Runtime of video: 4 mins 25 secs
