Outpatient double percutaneous endolaparoscopic extraction of large continent urinary reservoir stones--a new minimally invasive approach.

PURPOSE: We report an efficient new method of managing massive stone burdens in continent urinary reservoirs without urethral access, using the minimally invasive double percutaneous endolaparoscopic technique. PATIENTS AND METHODS: After first obtaining and dilating a percutaneous tract into the reservoir, a second access is established using a laparoscopic trocar 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 any stone fragments.
RESULTS: This technique was used successfully in 5 of 5 patients with continent reservoirs, achieving stone-free status without short-term or long-term (mean follow-up 32.4 months, range 9-61 months) complications.
CONCLUSION: Double percutaneous endolaparoscopic stone extraction is a safe, effective, and minimally invasive method of managing continent urinary reservoir stones.