Format

Send to

Choose Destination
Urology. 2010 Jan;75(1):96-9. doi: 10.1016/j.urology.2009.07.1216. Epub 2009 Oct 2.

A novel technique of intracorporeal excisional tailoring of megaureter before laparoscopic ureteral reimplantation.

Author information

1
Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Abstract

OBJECTIVES:

To present our initial results of a novel technique of intracorporeal laparoscopic tailoring of megaureter (MGU) and nonrefluxing reimplantation.

METHODS:

Three young male patients presented with flank pain (3) and recurrent urinary tract infection (2). Investigations revealed refluxing MGU in 2 and obstructing MGU in 1. Laparoscopic tailoring and reimplantation was planned. Ureteral mobilization was carried out using a standard 3-port access. An additional 5 mm port was inserted under vision for "dynamic" traction on ureter using a vessel loop without disconnecting the ureter from hiatus. This maneuver led to a fixed anatomic orientation and a firm platform of ureter greatly facilitating excisional tailoring and resuturing. After this, a ureteral stent was inserted through one of the laparoscopic ports and reimplantation of ureter was carried out in nonrefluxing fashion using extravesical, suprahiatal technique.

RESULTS:

No immediate postoperative complications were observed. Stents were removed 6 weeks after surgery. Pain resolved in 2 and greatly improved in 1. None of the patients developed urinary tract infection during follow up. Follow up studies revealed complete resolution of reflux in 1 patient with grade V reflux and residual minimally symptomatic high-pressure (voiding) grade II reflux in another. Patient with obstructive MGU has grade I asymptomatic reflux.

CONCLUSIONS:

Our technique of intracorporeal laparoscopic excisional tailoring of MGU is feasible and reproducible.

PMID:
19800667
DOI:
10.1016/j.urology.2009.07.1216
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center