Introduction: Massive encrustation is a rare complication of retained foreign bodies in the urinary tract. Large stone size and coexisting artificial material can limit endoscopic options, necessitating surgical removal. We present a case of massive encrustation of a retained ureteral stent treated with robotic-assisted laparoscopic (RAL) ureterolithotomy. Methods: We reviewed the medical records of a patient with massive encrustation of a retained ureteral stent placed one year prior in Colombia who was treated with RAL ureterolithotomy at our institution. Footage captured on the da Vinci Xi System was edited in Adobe Premiere to provide a video representation of our technique. A brief literature review was performed in MEDLINE, Emboss, and Preprints using the search term "robotic ureterolithotomy," which resulted in 88 studies. These were reviewed by two investigators for content and applicability, resulting in five studies included for review. Results: Case duration was 194 minutes with an estimated blood loss (EBL) of approximately 15 ml. There were no complications and the patient was discharged on post-op day three with a right ureteral stent and percutaneous nephrostomy tube. Her stent was removed at a subsequent follow-up visit, as was her nephrostomy tube following a successful clamp trial. Due to difficult social circumstances, she is pending follow-up for renal lasix scan. Review of the literature showed 100% stone free rates in adults treated with RAL ureterolithotomy. Our case duration and EBL were similar to published reports, although the stone was significantly larger, at approximately 13 cm. Conclusions: RAL ureterolithotomy is safe and effective in the treatment of massively encrusted ureteral stents. SOURCE OF Funding: None
