A 67-year-old man was referred to our hospital for evaluation of large urinary-diversion calculus. He had undergone urinary diversion for invasive bladder cancer with an Indiana pouch, when he was 52 years old. We performed the surgery using a laparoscopic trocar and an entrapment bag, for reducing the risk of bladder damage by the lithoclast and small residual fragments of the calculus. There has been no recurrence of stone formation 18 months after the surgery. This technique of percutaneous cystolithotomy of a large urinary calculus utilizing laparoscopic and endourologic instrumentation, is quick and safe, and can be used for complete stone removal, thereby decreasing the risk of recurrent stone formation.

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