INTRODUCTION: To describe a novel technique using extracorporeal tailoring and an inverted ureteral nipple to perform laparoscopic transperitoneal ureteral reimplantation for adult obstructed megaureter and our initial experience with 10 patients.
TECHNICAL CONSIDERATIONS: Ten patients (mean age 39.2 years [range, 21-62]) with adult obstructed megaureter underwent transperitoneal laparoscopic ureteral reimplantation by a 3- or 4-port technique. In each case, the affected ureter was freed and delivered out of the peritoneal cavity through the ipsilateral 12-mm port. The lower end of the ureter was tailored by approximately 6 cm, and the tip was folded back onto itself and secured with absorbable sutures to form a nipple. A double-J stent was placed, the entire assembly was carefully replaced into the abdomen, and the ureter was reimplanted into the posterolateral wall of the bladder.
CONCLUSION: Surgery was successful in all the 10 patients without the need for open conversion. At a mean follow-up of 17 months, all patients were asymptomatic, and hydronephrosis was relieved in 9 cases. Laparoscopic ureteral reimplantation with extracorporeal tailoring and direct nipple ureteroneocystostomy is an easy, safe, and effective procedure for adult obstructed megaureter.
Written by:
He R, Yu W, Li X, Yao L, He Z, Zhou L. Are you the author?
Department of Urology, Peking University First Hospital, Beijing, China; Institute of Urology, Peking University, Beijing, China; National Urological Cancer Center, Beijing, China.
Reference: Urology. 2013 Sep 12. pii: S0090-4295(13)00860-1.
doi: 10.1016/j.urology.2013.07.019
PubMed Abstract
PMID: 24035035
UroToday.com Endourology Section
