To explore the value of preoperative three-dimensional reconstruction and intraoperative ultrasound in the treatment of flexible ureteroscope for the treatment of renal parapelvic cysts.

From July 2017 to December 2018, 13 patients with paracentral cysts were treated with ureteroscope and holmium laser incision. There were 8 males and 5 females with an average age of (55±5) years, 7 patients on the left side and 6 cases on the right side. Preoperative planning of target sputum and ideal incision site based on CT three-dimensional reconstruction before operation, and guided and monitored by intraoperative ultrasound in real time, the cystic deformation of the cyst was the largest, that was, the thinnest part of the capsule wall, and the sac was used to cut the wall of the capsule. After observing the cystic cavity in the mirror, the incision range was expanded to the renal pelvis, and the double J tube was left after the operation.

All the 13 patients underwent surgery successfully. The best incision sites were located in the renal pelvis or renal pelvis rather than the renal pelvis. The operation time was 24-67 minutes, with an average of 38 minutes. There was no open surgery, no serious complications occurred, and hospitalized 2-4 days after operation, with an average of 3 days. After 3 to 12 months of follow-up, 10 cases of cysts disappeared, 3 cases of cysts were reduced more than 1/2, 3 cases of patients with renal calculi did not found obvious residual stones after 1 month of operation, 7 cases with back sore and swolley were significantly relieved after surgery.

Ureteroscopy combined with holmium laser in the treatment of pre-renal cysts under the guidance of three-dimensional reconstruction and intraoperative ultrasound is safe and feasible, and the incision position is preferred, the incision range is sufficient, the bleeding is less, the microscope is quick to find, and the operation is safe, and worth to be promote.