The role of laparoscopic surgery in the management of urinary lithiasis in the era of endourology in Mexico

Objective: The aim of the present study was to describe the results of a case series of laparoscopic pyelolithotomies and ureterolithotomies performed at the Hospital General de México and demonstrate that the laparoscopic management still has a place among the therapeutic options in our country. Material and methods: Retrospective analysis on patients that underwent laparoscopic pyelolithotomy or laparoscopic ureterolithotomy, within the time frame of 2013 and 2022. Intraoperative variables of blood loss, surgery duration, and complications; and the postoperative variables of hospital stay, time to double-J stent removal, and complications were analyzed. Results: 46 underwent laparoscopic pyelolithotomy and 29 underwent laparoscopic ureterolithotomy. Mean patient age was 45 years. Forty-three of the procedures were right-sided, 31 were left-sided, and there was one case of ectopic pelvic kidney. The pyelolithotomy results were: stone size of 24x20mm (8.8-60 x 5-60), 1034 HU, S.T.O.N.E. score of 6, surgery duration of 124 min, blood loss of 72ml, and hospital stay of 2.3 days. The ureterolithotomy results were: stone size of 22x11mm (10-80mm x 7.8-20), 980 HU, surgery duration of 101min, blood loss of 31ml, and hospital stay of 2.4 days. There were 3 intraoperative complications and 4 postoperative complications. Conclusión: Laparoscopic surgery can be a feasible and reproducible alternative to endourologic management, with good results, in large volume (>20mm) single stones.