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Recent advances in extracorporeal lithotripsy and endoscopic techniques have made open surgery infrequent for treatment of urinary stones. However, patients with large impacted stones, especially those located in the proximal ureter, pose a challenge for treatment, often requiring multiple interventions. In such cases, open surgery remains a good, cost-effective alternative for resolution.

The recent development of laparoscopic surgery has broadened the therapeutic options for several pathologies. The laparoscopic ureterolithotomy was initially described by Wickhan in 1979, and more widely divulged since the early 1990s by Gaur during the retroperitoneoscopic access.

Retroperitoneoscopic pyelolithotomy is an alternative that allows the removal of the intact stone with lower risk of residual fragments and without requiring transparenchymal access, thus reducing the risk of bleeding.

Minimally invasive surgical technique that uses a laparoscopically inflated balloon to create an artificial cavity in the retroperitoneum without opening the peritoneum.