PREOPERATIVE
DIAGNOSIS: Right ureteral stone.
POSTOPERATIVE
DIAGNOSIS: Right ureteral stone.
OPERATION
PERFORMED:
Cystoscopy
with right ureteroscopy and laser lithotripsy with stone basketing and right
ureteral stent placement.
OPERATIVE
FINDING: Right ureteral stone.
SPECIMEN: Right ureteral stone.
COMPLICATIONS: None.
ANESTHESIA:
General.
ESTIMATED
BLOOD LOSS: None.
PROCEDURE IN DETAIL:
The patient was brought to the operating room, placed in the
operating room table. After general anesthesia
and IV Levaquin was given he was put in lithotomy position. The external genitalia was prepped and draped
in standard surgical fashion. A
#22-French cystoscope was introduced into his bladder. His anterior urethra and prostate were within
normal limits. The bladder was then
entered, there were no suspicious lesions, stones or foreign bodies. Attention was turned to the right ureteral
orifice, a sensor wire was used to intubate the right ureter. This was passed proximally all the way up
into the kidney is visualized under fluoroscopy. At this point the cystoscope was removed
while leaving the sensor wires in place.
A short semirigid ureteroscope was then passed into the bladder and into
the distal right ureter. The calculus
was visualized. There was small area of
stricturing just distal to the stricture.
There were small area of stenosis just distal to the stone that was
easily negotiated with the ureteroscope after the stone was visualized with a
325 micron fibre was used to fragment the stone into smaller pieces. A 0-tip 3-wire basket was then used to
extract all the stone fragments and the ureter was _____ and the specimen
labeled right ureteral stone. At this point
#22-French cystoscope was then back loaded over the sensor wire, a 6x24 double-J
ureteral stent were then passed through the cystoscope up the wire into the
right kidney when the sensor wire was removed the proximal end of the ureteral
stent was seen to coil in the renal pelvis under fluoroscopy and the distal end
of the stent was seemed to coil in the bladder under cystoscopic vision. The bladder was then emptied and the
cystoscope was removed. The ureteral
stent was left with the string attached and this was brought out to the
phallus. There were no
complications. He was awaken and
transported to the recovery room in stable condition.
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