Laparoscopic cystolithotomy

When is it needed?

Laparoscopic cystolithotomy is used in the case of large stones located in the urine bladder, where endoscopic measures are otherwise too long, or inapplicable due to safety risks.

How is it performed?

In order to perform laparoscopic cystolithotomy, we require 4 trocars inserted at the bottom half of the stomach wall. The extraperitoneal approach is made possible through balloon dilation which forms an artificial space in front of the peritoneum (the inner membrane tissue of the stomach) where the trocars are then placed. After detaching the fatty tissue off the urine bladder wall, we open the bladder in order to remove the stone in its entirety without first having to break it down. Having placed the post-operative urinary catheter, the bladder wall is closed, and drainage tube is inserted in order to monitor and control possible bleeding, as well as urine secretion. The endoscopic bag and the stone within is removed through an extended incision made at one of the trocars. The remaining trocars are removed, and the incisions are stitched up.

What are the possible complications?

Complications in laparoscopic cystolithotomies are rare. The most common possible complication is bleeding, which rarely requires a blood transfusion. Approximately less than 0.5% of laparoscopic cystolithotomies require a conversion to the open surgical approach.