A simple technique for retroperitoneal laparoscopic JJ stenting of the ureter

Gaur, D.D.; Joshi, Nayan; Dubey, Mithilesh Kumar; Acharya, Upasana

doi:10.1046/j.1464-410x.2003.04184.x

Cited by 15 publications

(8 citation statements)

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“…8 In this technique the stent is passed over the stilet, cut just short of the stent length and pushed with the Except in poorly functioning units in clinical practice hardly any advantage is gained by doing RGP after information regarding the ureter is available on excretory urography or sonography. 4 Retrograde pyelography sometimes leads to inadvertent injury to the UVJ, marring the prospects of continuing the planned procedure.…”

Section: Discussionmentioning

confidence: 99%

Is Antegrade Stenting Superior to Retrograde Stenting in Laparoscopic Pyeloplasty?

2004

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Section: Discussionmentioning

confidence: 99%

Is Antegrade Stenting Superior to Retrograde Stenting in Laparoscopic Pyeloplasty?

2004

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“…Moreover, cystoscopic retrograde stenting is associated with risks due to advancing the suture site without direct visualization. Alongside these retrograde cystoscopic or ureteroscopic stenting techniques, several intracorporeal stenting techniques have previously been described [25–28]. However, these techniques require fluoroscopic confirmation of correct placement after closing the ureter.…”

Section: Discussionmentioning

confidence: 99%

The usefulness of flexible cystoscopy for preventing double-J stent malposition after laparoscopic ureterolithotomy

et al. 2017

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BackgroundThe aim of this study was to evaluate the role of flexible cystoscopy in preventing malpositioning of the ureteral stent after laparoscopic ureterolithotomy in male patients.MethodsFrom April 2009 to June 2015, 97 male patients with stones >1.8 cm in the upper ureter underwent intracorporeal double-J stenting of the ureter after laparoscopic ureterolithotomy performed by four different surgeons. In the last 50 patients who underwent laparoscopic ureterolithotomy flexible cystoscopy was performed through the urethral route to confirm the position of the double-J stent, while in the first 47 correct positioning of the stent was confirmed through postoperative KUB. The demographic data and perioperative outcomes were reviewed retrospectively. Penalized logistic regression analysis was used to evaluate the effects of flexible cystoscopy.ResultsUpward malpositioning of the ureteral stent was found in 9 of the 47 (19.1%) patients who underwent surgery without flexible cystoscopy. Among the 50 most recent patients who underwent surgery with flexible cystoscopy through the urethral route, upward malpositioning was observed in 10 (20%) patients. The factors preventing upward malpositioning of the double-J catheter in multivariate analysis were surgeon (p = 0.039) and use of flexible cystoscopy (p = 0.008).ConclusionFlexible cystoscopy is a simple, safe, quick, and effective method to identify and correct malpositioning of double-J stents, especially in male patients.Trial registrationThis study was registered with ClinicalTrials.gov Registry on May 11, 2017 (retrospective registration) with a trial registration number of NCT03150446.Electronic supplementary materialThe online version of this article (doi:10.1186/s12894-017-0232-4) contains supplementary material, which is available to authorized users.

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“…Pneumotoraksas ar pneumomediastinumas gerokai daþniau bûna operuojant ekstraperitoniniu (37%) nei transperitoniniu (3%) bûdu. D. D. Gaur [30,31] nurodo, kad apie 20% ligoniø po operacijos dël siûliø nepakankamumo ilgai (>7 dienas) pro drenà tekëjo ðlapimas, operacijos metu neteko 5-100 ml kraujo, vidutiniðkai -25 ml, operacijos laiko vidurkis stentuojant ir susiuvant ðlapimtaká -1 val. 32 min.…”

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Šlapimtakio akmenų chirurginis gydymas laparoskopiniu ir retroperitoneoskopiniu būdais: literatūros apžvalga ir pirmieji rezultatai

Šilinis¹,

Gradauskas²,

Mičelytė³

2006

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Darius Šilinis1, Audrius Gradauskas2, Stasė Mičelytė31 Vilniaus universiteto Medicinos fakulteto Gastroenterologijos, nefrologijos,urologijos ir abdominalinės chirurgijos klinika,2 Vilniaus universiteto Medicinos fakulteto Vidaus ligų pagrindų ir slaugos katedra,3 Vilniaus miesto universitetinės ligoninės Urologijos skyrius,Antakalnio g. 57, LT-10207 VilniusEl. paštas: darius.silinis@one.lt Įvadas / tikslas Inkstų ir šlapimtakių akmenligė išlieka labai aktuali liga, jos etiopatogenezė iki šiol nėra visai aiški. Akmenligės gydymo istorija siekia tolimus amžius. Žmonija nuėjo ilgą kelią, kol pasiekė dabartinį gydymo lygį. Šiuo metu atviros akmenų šalinimo operacijos praktiškai nebeatliekamos, jas pakeitė minimaliai invazinės endoskopinės, o pastaruoju metu – ir laparoskopinės operacijos. Metodai Vilniaus miesto universitetinėje ligoninėje ir VUL Santariškių klinikose per metus atlikta dešimt šlapimtakio akmenų šalinimo laparoskopinių operacijų retroperitoneoskopiniu būdu. Operuota suformavus dirbtinę ertmę užpilvaplėviniame tarpe, pašalinti ne mažesni nei 1 cm skersmens akmenys, įstrigę šlapimtakyje ne mažiau kaip mėnesį. Visais atvejais stentuotas ir susiūtas šlapimtakis, drenuota šlapimtakio defekto sritis. Rezultatai Operuoti 6 vyrai ir 4 moterys nuo 22 iki 81 metų. Šalinti akmenys iš šlapimtakio viršutinio segmento 8 atvejais, iš vidurinio – 2 atvejais. Akmenų dydis – nuo 1 cm iki 2 cm, įstrigimo laikas – nuo 4 savaičių iki 60 savaičių. Visais atvejais bandyta akmenis suskaldyti ESWL būdu. Iš 10 operacijų devynios atliktos sėkmingai, viena konvertuota į atvirąją dėl kraujavimo. Vidutinė operacijos trukmė – 2 val. 05 min. Išvados Pirmieji atvejai parodė, kad tai saugus, mažai traumuojantis šlapimtakio akmenų chirurginis gydymo būdas. Pirmieji atvejai buvo susiję su techninėmis kliūtimis, patirties stoka ir komplikacijomis, bet naujausios operacijos teikia vilčių, kad įgyjant patyrimo šis metodas taps veiksmingu pirmo pasirinkimo gydymo būdu dideliems, seniai įstrigusiems šlapimtakio akmenims šalinti. Reikšminiai žodžiai: laparoskopija, retroperitoneoskopija, šlapimtakių akmenys, istorija, pirmieji rezultatai Laparoscopic and retroperitoneoscopic surgical treatment of ureteral stones: literature review and the first results Darius Šilinis1, Audrius Gradauskas2, Stasė Mičelytė3.1 Vilnius University, Faculty of Medicine, Clinic of Gastroenterology, Nefrology,Urology and Abdominal Surgery,2 Vilnius University, Faculty of Medicine, Department of the Fundamentalsof Internal Diseases and Nursing,3 Vilnius City University Hospital, Urology Department,Antakalnio 57, LT-10207 Vilnius, LithuaniaE-mails: darius.silinis@one.lt Background / objective Kidney and ureteral stone disease is still actual. Its etiopathogenesis is not well known. The history of nephrolithiasis treatment reaches back to early ages. Open stone removal operations are very rare at present, minimal invasive endoscopic and now laparoscopic operations being preferred. Methods During a year, 10 laparoscopic or retroperitoneoscopic ureteral stone removal operations have been performed at the Vilnius city university hospital. During the operations retroperitoneal cavity has been performed, the removed stones were 1 cm or more in size, blocking the ureter for no less than 1 month. In all cases a ureteral stent has been inserted and the ureter sutured, with draining the cavity near the suture. Results Patients: 6 male and 4 female aged 22 to 81 years. Stones were removed from the upper third of the ureter in 8 cases and from the middle part in 2 cases. Stone size was from 1 cm to 2 cm, the time of obstruction from 4 to 60 weeks. In all cases ESWL had been performed before the operation. In 9 of 10 cases the operation was successful; only one case was converted into an open operation because of bleeding. Operation mean time was 2 h 05 min. Conclusions The first cases showed that laparoscopic operation is a safe, minimal traumatic method of ureteral stone removal. In the first cases there were technical problems, lack of experience, complications, but the last operations allow to expect that this method will become the first choice in the treatment of large, old blocking ureteral stones in the future. Key words: laparoscopy, retroperitoneoscopy, ureteral stones, history, first results

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A simple technique for retroperitoneal laparoscopic JJ stenting of the ureter

Cited by 15 publications

References 1 publication

Is Antegrade Stenting Superior to Retrograde Stenting in Laparoscopic Pyeloplasty?

Is Antegrade Stenting Superior to Retrograde Stenting in Laparoscopic Pyeloplasty?

The usefulness of flexible cystoscopy for preventing double-J stent malposition after laparoscopic ureterolithotomy

Šlapimtakio akmenų chirurginis gydymas laparoskopiniu ir retroperitoneoskopiniu būdais: literatūros apžvalga ir pirmieji rezultatai

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