Cystoscopy with right ureteroscopy and laser lithotripsy with stone basketing and right ureteral stent placement

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.