Extracorporeal Ureteric Stenting for Pediatric Laparoscopic Pyeloplasty

Kocherov, Stanislav; Lev, Genady; Chertin, Leonid; Chertin, Boris

doi:10.1055/s-0035-1546756

Cited by 9 publications

(9 citation statements)

References 16 publications

(28 reference statements)

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“…Previously Guliev has described a technique using retroperitoneoscopic access based on 178 cases, which showed the effectiveness of the procedure and was associated with relatively little trauma, a quick recovery, and good cosmetic effects [10]. However, such a great efficiency is reachable only for experienced surgeons, whereas an unconventional technique of laparoscopic surgery has been developed to circumvent possible issues with residents benefitting from this the most [4][5][6][7][8][9]. In order to optimize anastomosis creation in patients with hydronephrosis at the stage of mastering laparoscopic pyeloplasty, we employed extracorporeal ureter handling.…”

Section: Resultsmentioning

confidence: 99%

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Extracorporeal ureter handling during laparoscopic pyeloplasty: tips and tricks for beginners

Enikeev

Gahan

Yossepowitch

et al. 2019

Cent european J Urol

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be handled delicately and precisely. While improved surgical equipment may contribute to improved outcomes, surgeon experience was often cited as the main indicator for successful surgery. Principles of reconstructive surgery of the upper urinary tract remain the same regardless of approaches used (open, laparoscopic or robot-assisted). During laparoscopy, preparing the surfaces of the urinary tract

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Section: Resultsmentioning

confidence: 99%

“…Cases with narrow ureters are the most difficult to manage [3]. The above-mentioned aspects have led to some precise intracorporeal steps of laparoscopic reconstructive surgery becoming substituted with extracorporeal steps [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

Extracorporeal ureter handling during laparoscopic pyeloplasty: tips and tricks for beginners

Enikeev

Gahan

Yossepowitch

et al. 2019

Cent european J Urol

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“…We also consider the use of external pyelostomas or drainless methods in children of the younger group possible, but for very limited indications, since they pose an unreasonable risk of infection, impaired UPJ or stoma, risk of UPJ injury, urinary leakage, and a decrease in the quality of life in the postoperative period. The stenting technique we used was described in adults and in children, where excellent results were obtained in an efficient and quick installation (11,12). The thin abdominal wall simplified extracorporeal excretion of the ureter, spatulation, first suture and stent placement.…”

Section: Discussionmentioning

confidence: 99%

Simplified Stenting Methods during Laparoscopic Pyeloplasty in Children

Bishmanov¹,

Alchinbayev

2020

Electron J Gen Med

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Citation: Bishmanov R, Alchinbayev M. Simplified Stenting Methods during Laparoscopic Pyeloplasty in Children. Electron J Gen Med. 2020;17(5):em236. https://doi.org/10.29333/ejgm/7935 ARTICLE INFO ABSTRACTWe are dedicated to evaluate a simplified methods for ureteric stent insertion during laparoscopic pyeloplasty in children.After detect the cause of obstruction, UPJ resection was made. At that stage, we performed antegrade extracorporeal installation of stent by removing the proximal ureter through the lower skin defect after extraction of the trocar. That allowed for successful stenting under precise tactile and visual control. Then the ureter was reintroduced back into abdominal cavity. Dismembered LP by Hynnes-Andersen technique was made using 6/0 absorbable monofilament suture. The second method of ureteric stenting: after the anastomosis of posterior pelvis wall is complete, puncturing with Veress needle between the optics and the upper trocar. The stylet was removed, after that we can introduce a stent through the needle hole with ensure accurate tactile sensations, maximum control over the stent direction.Since January 2017, we have used this method in 32 children with congenital hydronephrosis were operated by LP. The proposed methods of ureteric stenting allowed reducing that stage to 3-10 minutes, with successful outcome in all cases. The children were discharged 5-7 days after surgery.No conversion to open surgery had to be performed.Our experience shows that LP in children with congenital HN reduces the surgical burden on the patient, improves post-surgery quality of life. The proposed methods of antegrade intraoperative stenting significantly reduce the duration of surgery while improving the success rate of this key manipulation.

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“…Kocherov et al . [6] exteriorized the pelvis after deflating abdomen and performed open antegrade stenting. Chandrasekharam[7] found antegrade stenting less successful in children with a mean age of 1.5 years and favored retrograde stenting.…”

Section: Discussionmentioning

confidence: 99%

Stenting antegrade via veress needle during laparoscopic PyeloplastY (“SAVVY” Technique)

Babu

Arora

Raj

2019

J Indian Assoc Pediatr Surg

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Aim:The aim of the study is to report the outcomes of different stenting techniques during laparoscopic pyeloplasty (LP).Materials and Methods:This study was a retrospective audit of duration of stenting, complications encountered, and operative outcomes of LP in children older than 3 years.Results:Retrograde cystoscopic prestenting took significantly longer time (17.2 min) and the presence of stent hindered in anastomosis. Antegrade stenting without guide wire took longer time (9.6 min), and in some, there was difficulty in negotiating distal ureter. Antegrade stenting over guide wire, through a 14-gauge intravenous cannula, took significantly less time (7.3 min) although the cannula got kinked and the stenting was difficult in some as the length of the cannula was short and it did not reach anastomotic site. “Stenting Antegrade Via Veress needle during laparoscopic pyeloplastY” (“SAVVY” technique) favored by authors has the least stenting duration (4.8 min) and minimum failures (P = 0.01, ANOVA). The needle is wide enough to pass a 4-Fr stent and long enough to reach the anastomotic site.Conclusion:SAVVY technique saves time during LP with least failures and is a useful stenting technique in children.

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Extracorporeal Ureteric Stenting for Pediatric Laparoscopic Pyeloplasty

Abstract: Our data show that extracorporeal antegrade ureteric stent insertion is an easy-to-learn and a safe and reliable technique for pediatric dismembered pyeloplasty. It obviates the problem of having the stent in the pelvis during dissection and the need for patient repositioning.

Cited by 9 publications

References 16 publications

Extracorporeal ureter handling during laparoscopic pyeloplasty: tips and tricks for beginners

Extracorporeal ureter handling during laparoscopic pyeloplasty: tips and tricks for beginners

Simplified Stenting Methods during Laparoscopic Pyeloplasty in Children

Stenting antegrade via veress needle during laparoscopic PyeloplastY (“SAVVY” Technique)

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