Minimal and direct access ureterolithotomy.

Authors developed an alternative method to laparoscopic surgery for ureterolithotomy. The surgery is of minimal access because the length of the single skin incision ranges from 3 to 4 cm, depending on the type of exploration. It is of direct access because the surgeon sees the operative area directly and stereoscopically with his own two eyes without video-optical support. The procedure requires a special open-lumen retractorscope (Jakoscope) with a high intensity fiberoptic light system and modified standard hand instruments. Ureterolithotomy is operated retroperitoneally through a minilumbotomy incision. The procedures are simple, rapid and the instruments are inexpensive. The postoperative pain and morbidity are comparable to the laparoscopic approach.