Laparoscopic Ureterocalicostomy Technique

Abstract

Purpose: Ureterocalicostomy is a technique that was first described by Neuwirt in 1948 ( 1 ) The laparoscopic access was initiated in 2003 by Cherullo et al. ( 2 ), following the established principles of open surgery. In 2004, Gill et al. had two patients with UPJO treated with laparoscopic ureterocalicostomy, with success ( 3 ). In 2014, Arap et. al. presented a case series with good results in adults and children in our service ( 4 ). There are factors that prepare the surgeon for an ureterocalicostomy, such as the renal cortex thickness, although the decision is mainly taken during the procedure ( 5 ). Material and Methods: A 24 years-old female patient with right lumbar pain was referred to our institution. She already had a right open pyeloplasty two years ago. The CT scan presented a right hydronephrotic kidney, DMSA scan with 30% of relative function and a DTPA scan with an obstructive pattern. Results: A laparoscopic ureterocalicostomy was performed due to the intra-operative findings (inferior kidney pole thickness and challenging access to the uretero-pelvic junction). The overall time was 130 minutes with no complications. The patient was discharged in two days and the double J was withdrawn in four weeks. The CT scan within one year demonstrates a reduction of the hydronephrosis. She had no more lumbar pain. Conclusion: In complex cases, the laparoscopic ureterocalicostomy proves to be a safe and efficient procedure, with a free tension-free anastomosis and the advantages of the laparoscopic access.

Ureterocalicostomy for complex upper ureteral stricture: a narrative review of the current literature

“…A radionuclide scan conducted 1 year after the surgery indicated that the bilateral renal function levels were comparable, ultrasound showed no remaining hydronephrosis, and the urinary flow of the affected kidney was unobstructed [ 38 ]. In two case reports [ 16 , 34 ], both patients underwent UC due to obstruction of the ureteropelvic junction following pyeloplasty. The operation was successfully performed, and postoperative follow-up results demonstrated significant improvement in hydronephrosis with no evidence of anastomotic obstruction.…”

“…However, with the continuous exploration of surgeons and the advancements in laparoscopic technology, laparoscopic or robot-assisted laparoscopic ureterocalicostomy (LUC or RALUC) has been increasingly performed on patients with severe hydronephrosis caused by complex upper ureteral stricture and obstruction. These procedures have shown satisfactory results [ 14 – 16 ]. A comprehensive search was performed using the PubMed database by entering the search term “ureterocalicostomy” to collect relevant studies on UC.…”

Selection of best videos of the year for 2023

“…They are to be congratulated on their significant contribution to the field, understanding that such cases should only be completed in the setting of a clinical trial and by highly skilled minimally invasive surgeons, with a low threshold for open conversion if adequacy of surgical resection is at all felt to be compromised. The second prize for best video of the year is awarded to Nunes, et al from the University of São Paulo for their submission entitled “Laparoscopic ureterocalicostomy technique” published in volume 49, number 3 of our journal ( 2 ). As we all know, reconstruction using an ureterocalicostomy is infrequently completed by even experienced urologists so this publication using a minimally invasive approach and marvelously captured and described represents an invaluable resource for urologists and trainees.…”