LAPAROSCOPIC MANAGEMENT OF UPPER URINARY TRACT STONES: AN EIGHT-YEAR SINGLE-CENTRE EXPERIENCE: A RETROSPECTIVE CASE SERIES OF 13 PATIENTS (2013-2021)

Background: Laparoscopic stone surgery now occupies a selective role between endourological treatment and open surgery. This study describes the indications, feasibility, and outcomes of laparoscopic treatment for upper urinary tract stones at a tertiary Moroccan centre. 
Methods: We retrospectively reviewed 13 consecutive patients who underwent laparoscopic stone extraction in the Department of Urology, Hassan II University Hospital, Fez, from January 2013 to January 2021. Demographic, clinical, laboratory, radiological, operative, and postoperative variables were extracted from the source database. 
Results: Out of 200 cases of upper urinary tract stones managed over 8 years, 13 patients underwent laparoscopic treatment. The average age of our patients was 56 years, with a sex ratio of 1.16. Thirteen laparoscopic procedures were performed: 11 ureterolithotomies and 2 pyelolithotomies, including one stone extraction in a patient with junctional obstruction. Complete stone-free success was noted in 12 of the 13 patients who underwent laparoscopic stone extraction (92.30%). Only one patient developed a postoperative complication: atrial fibrillation tachycardia.
Conclusion: In this small, highly selected series, laparoscopy achieved a high single-session stone-free rate with no conversion. Its contemporary role is best viewed as a rescue or reconstructive option for large impacted stones, failed or unsuitable endourological treatment, and stones associated with anatomical abnormalities, provided appropriate laparoscopic expertise is available.